Healthcare Provider Details

I. General information

NPI: 1417675687
Provider Name (Legal Business Name): OPTIMUM HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2022
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23031 TABAK LN
LAND O LAKES FL
34639-5230
US

IV. Provider business mailing address

23031 TABAK LN
LAND O LAKES FL
34639-5230
US

V. Phone/Fax

Practice location:
  • Phone: 813-856-1515
  • Fax: 813-336-8922
Mailing address:
  • Phone: 813-856-1515
  • Fax: 813-336-8922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: HEATHER HUGHES
Title or Position: OWNER
Credential: APRN
Phone: 813-856-1515