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General NPI Number Information
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NPI Number | 1639788680
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Entity Type | Organization
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Legal Business Name | OPTIMAL FAMILY CARE & AESTHETICS
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 2001 N FEDERAL HWY UNIT 219
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City | POMPANO BEACH
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State | FL
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Zip | 33062-1039
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Country | US
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Telephone | 954-933-7164
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Fax |
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Provider Business Mailing Address
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Address Line | 11419 W PALMETTO PARK RD UNIT 970032
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City | BOCA RATON
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State | FL
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Zip | 33497-2503
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Country | US
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Telephone | 954-933-7164
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Fax | 954-933-1986
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Authorized Official
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Title or Position | ARNP/FAMILY NURSE PRACTITIONER
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Name | EGLANTE NOEL
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Credential |
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Telephone | 561-901-3779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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