Healthcare Provider Details

I. General information

NPI: 1326814245
Provider Name (Legal Business Name): TU SALUD OPTIMAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2023
Last Update Date: 03/08/2024
Certification Date: 03/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6266 S CONGRESS AVE # 11
LAKE WORTH FL
33462-2375
US

IV. Provider business mailing address

6266 S CONGRESS AVE # 11
LAKE WORTH FL
33462-2375
US

V. Phone/Fax

Practice location:
  • Phone: 786-277-1621
  • Fax:
Mailing address:
  • Phone: 786-277-1621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FARAH BAUDIN
Title or Position: OFFICE CONSULTANT
Credential:
Phone: 786-277-1621