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General NPI Number Information
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NPI Number | 1629456314
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Entity Type | Organization
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Legal Business Name | OPTIMUM HEALTH MEDICAL CARE, PLLC
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Dates
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Enumeration Date | 05/13/2015
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Last Update Date | 05/13/2015
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Provider Practice Location Address
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Address Line | 10524 MOSS PARK RD SUITE 204-187
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City | ORLANDO
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State | FL
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Zip | 32832-5898
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Country | US
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Telephone | 407-629-1599
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Fax |
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Provider Business Mailing Address
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Address Line | 10524 MOSS PARK RD SUITE 204-187
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City | ORLANDO
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State | FL
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Zip | 32832-5898
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. NAFEESA MAHMOOD
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Credential | M.D.
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Telephone | 407-766-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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