Healthcare Provider Details

I. General information

NPI: 1265390942
Provider Name (Legal Business Name): OPTIMAL HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3168 PEPPERTREE DR
MIDDLEBURG FL
32068-8200
US

IV. Provider business mailing address

3168 PEPPERTREE DR
MIDDLEBURG FL
32068-8200
US

V. Phone/Fax

Practice location:
  • Phone: 904-291-2648
  • Fax: 904-291-0002
Mailing address:
  • Phone: 904-291-2648
  • Fax: 904-291-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BONNIE S EVANS
Title or Position: CEO
Credential:
Phone: 904-291-2648