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General NPI Number Information
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NPI Number | 1912899113
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Entity Type | Organization
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Legal Business Name | OPTIMUM HEALTH MEDICAL GROUP, LLC.
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Dates
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Enumeration Date | 07/21/2025
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 11082 S MILITARY TRL STE B46
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City | BOYNTON BEACH
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State | FL
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Zip | 33436-7217
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Country | US
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Telephone | 561-705-7978
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Fax |
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Provider Business Mailing Address
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Address Line | 14280 S MILITARY TRL UNIT 6902
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City | DELRAY BEACH
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State | FL
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Zip | 33484-2628
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Country | US
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Telephone | 561-705-7978
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | OPTIMUM HEALTH MEDICAL GROUP
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Credential |
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Telephone | 561-705-7978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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