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General NPI Number Information
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NPI Number | 1275921777
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Entity Type | Organization
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Legal Business Name | OPTIMAL PATIENT CARE LLC
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Dates
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Enumeration Date | 01/06/2015
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Last Update Date | 01/06/2015
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Provider Practice Location Address
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Address Line | 8225 STATE ROAD 54
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-3016
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Country | US
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Telephone | 727-372-5206
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Fax | 727-372-8474
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Provider Business Mailing Address
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Address Line | 4319 E 7TH AVE
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City | TAMPA
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State | FL
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Zip | 33605-4628
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Country | US
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Telephone | 813-961-8262
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Fax | 813-961-8264
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Authorized Official
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Title or Position | PRESIDENT
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Name | FERMIN BACALSO ROTEA
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Credential | PT
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Telephone | 813-310-1526
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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