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General NPI Number Information
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NPI Number | 1710416128
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Entity Type | Organization
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Legal Business Name | OPTIMUM HEALTH & NUTRITION, LLC
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3261 SW 64TH TERRACE
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City | MIRAMAR
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State | FL
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Zip | 33023
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Country | US
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Telephone | 954-445-5322
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Fax |
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Provider Business Mailing Address
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Address Line | 3261 SW 64TH TER
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City | MIRAMAR
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State | FL
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Zip | 33023-3841
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Country | US
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Telephone | 954-445-5322
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOE WILLIAMS
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Credential | RRT,CPT,CNC
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Telephone | 954-445-5322
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 3447
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | RT8352
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License Number State | FL
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