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General NPI Number Information
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NPI Number | 1881002400
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Entity Type | Organization
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Legal Business Name | OPTIMAL HEALTH CHOICE AT SAWGRASS LLC
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 07/28/2014
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Provider Practice Location Address
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Address Line | 12651 W. SUNRISE BLVD SUITE 101
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City | SUNRISE
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State | FL
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Zip | 33323
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Country | US
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Telephone | 954-845-0187
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Fax | 954-845-0186
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Provider Business Mailing Address
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Address Line | 12651 W. SUNRISE BLVD - SUITE 101
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City | SUNRISE
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State | FL
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Zip | 33323
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Country | US
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Telephone | 954-845-0187
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Fax | 954-845-0186
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Authorized Official
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Title or Position | MNGR
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Name | MR. EMMANUEL ORELUS
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Credential | MD.
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Telephone | 954-845-0187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | ME112654
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License Number State | FL
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