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General NPI Number Information
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NPI Number | 1326622648
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Entity Type | Organization
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Legal Business Name | OPTIMA HEALTH INSTITUTE INC
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 1456 E MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32806-4817
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Country | US
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Telephone | 407-420-7691
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Fax | 833-748-0134
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Provider Business Mailing Address
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Address Line | 1456 E MICHIGAN ST
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City | ORLANDO
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State | FL
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Zip | 32806-4817
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Country | US
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Telephone | 407-420-7691
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Fax | 833-748-0134
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Authorized Official
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Title or Position | BILLER
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Name | MRS. DEBORAH ROARK
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Credential |
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Telephone | 727-420-6646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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