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General NPI Number Information
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NPI Number | 1942507298
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Entity Type | Organization
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Legal Business Name | OPTIMA MEDICAL OF SOUTH FLORIDA INC
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 2925 10TH AVE N STE 201B
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City | PALM SPRINGS
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State | FL
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Zip | 33461-3046
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Country | US
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Telephone | 561-629-7369
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Fax |
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Provider Business Mailing Address
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Address Line | 2925 10TH AVE N STE 201B
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City | PALM SPRINGS
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State | FL
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Zip | 33461-3046
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Country | US
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Telephone | 561-629-7369
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EHSANUL KARIM
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Credential | M.D.
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Telephone | 561-629-7369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME 95872
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License Number State | FL
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