Healthcare Provider Details

I. General information

NPI: 1396345302
Provider Name (Legal Business Name): JFM OPTIMA CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2020
Last Update Date: 10/28/2020
Certification Date: 10/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14653 ARGOS PL
UPPER MARLBORO MD
20774-8612
US

IV. Provider business mailing address

14653 ARGOS PL
UPPER MARLBORO MD
20774-8612
US

V. Phone/Fax

Practice location:
  • Phone: 301-755-7268
  • Fax:
Mailing address:
  • Phone: 301-755-7268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: OMOTAYO AKINNIRANYE
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 301-755-7268