Healthcare Provider Details

I. General information

NPI: 1437717212
Provider Name (Legal Business Name): OPTIMIZE REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 SE 7TH ST
DEERFIELD BEACH FL
33441-5813
US

IV. Provider business mailing address

1613 SE 7TH ST
DEERFIELD BEACH FL
33441-5813
US

V. Phone/Fax

Practice location:
  • Phone: 484-894-3207
  • Fax:
Mailing address:
  • Phone: 484-894-3207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN BLOCKI
Title or Position: OWNER
Credential: OTR/L
Phone: 484-894-3207