Healthcare Provider Details

I. General information

NPI: 1972810414
Provider Name (Legal Business Name): OPTIONAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8448 WHITE POPLAR DR
RIVERVIEW FL
33578-8634
US

IV. Provider business mailing address

8448 WHITE POPLAR DR
RIVERVIEW FL
33578-8634
US

V. Phone/Fax

Practice location:
  • Phone: 813-892-9888
  • Fax:
Mailing address:
  • Phone: 813-892-9888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number215740
License Number StateFL

VIII. Authorized Official

Name: MS. TAMMY FOSTER-KNIGHT
Title or Position: OWNER-CEO
Credential:
Phone: 813-892-9888