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General NPI Number Information
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NPI Number | 1679346266
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Entity Type | Organization
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Legal Business Name | OPTIMIZE HEALTH LLC
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Dates
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Enumeration Date | 11/06/2023
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 710 SW 64TH WAY
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City | PEMBROKE PINES
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State | FL
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Zip | 33023-1540
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Country | US
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Telephone | 305-492-5175
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Fax |
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Provider Business Mailing Address
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Address Line | 710 SW 64TH WAY
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City | PEMBROKE PINES
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State | FL
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Zip | 33023-1540
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Country | US
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Telephone | 305-492-5175
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | KORITA JOHNSON
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Credential | DNP
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Telephone | 305-492-5175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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