Healthcare Provider Details

I. General information

NPI: 1912702028
Provider Name (Legal Business Name): HEALTH OPTIMIZATION TREATMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2025
Last Update Date: 02/19/2025
Certification Date: 02/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N STE 24689
ST PETERSBURG FL
33702-4305
US

IV. Provider business mailing address

8 LAURELWOOD CT
SAINT LOUIS MO
63146-4940
US

V. Phone/Fax

Practice location:
  • Phone: 314-279-4565
  • Fax:
Mailing address:
  • Phone: 314-279-4565
  • Fax: 309-326-4526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ALISHA MICHELLE JONES
Title or Position: OWNER
Credential: FNP-C
Phone: 314-279-4565