Healthcare Provider Details

I. General information

NPI: 1164898276
Provider Name (Legal Business Name): OPTIMAL BILLING & SERVICES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5290 NW 4TH ST
MIAMI FL
33126-5030
US

IV. Provider business mailing address

5290 NW 4TH ST
MIAMI FL
33126-5030
US

V. Phone/Fax

Practice location:
  • Phone: 786-657-1607
  • Fax:
Mailing address:
  • Phone: 786-657-1607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: NOEL E PEDRAZA
Title or Position: PRESIDENTE
Credential:
Phone: 786-657-1607