Healthcare Provider Details

I. General information

NPI: 1013799550
Provider Name (Legal Business Name): OPTIMIZE HEALTH 360
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 BALD EAGLE DR STE 201
MARCO ISLAND FL
34145-2731
US

IV. Provider business mailing address

606 BALD EAGLE DR STE 201
MARCO ISLAND FL
34145-2731
US

V. Phone/Fax

Practice location:
  • Phone: 239-394-7221
  • Fax:
Mailing address:
  • Phone: 239-394-7221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GREG DENUNZIO
Title or Position: OWNER
Credential: DC
Phone: 651-592-5301