Healthcare Provider Details

I. General information

NPI: 1164664744
Provider Name (Legal Business Name): OPTIMAL BEING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2009
Last Update Date: 03/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

499 E. CENTRAL PKWY. STE. 215
ALTAMONTE SPRINGS FL
32701
US

IV. Provider business mailing address

143 EASTERN FORK
LONGWOOD FL
32750
US

V. Phone/Fax

Practice location:
  • Phone: 407-701-7841
  • Fax: 407-332-1206
Mailing address:
  • Phone: 407-701-7841
  • Fax: 407-332-1206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP1781
License Number StateFL

VIII. Authorized Official

Name: MONIQUE ROGERS
Title or Position: ACUPUNCTURE PHYSICIAN
Credential: A.P., D.O.M.
Phone: 407-701-7841