Healthcare Provider Details

I. General information

NPI: 1962133249
Provider Name (Legal Business Name): OPTIMUM PHYSICAL THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2022
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 SW 3RD AVE APT 208
BOCA RATON FL
33432-4767
US

IV. Provider business mailing address

50 SW 3RD AVE APT 208
BOCA RATON FL
33432-4767
US

V. Phone/Fax

Practice location:
  • Phone: 561-302-5820
  • Fax:
Mailing address:
  • Phone: 561-302-5820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID WARREN ADELMAN
Title or Position: MGR
Credential: DPT
Phone: 561-302-5820