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NPI Code Detail

MEDICARE: OPTUMCARE FLORIDA LLC

MEDICARE: OPTUMCARE FLORIDA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianFL
2207R00000XInternal Medicine PhysicianFL
3208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053384214
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTUMCARE FLORIDA LLC
Provider Business Mailing Address
First Line : 5130 SUNFOREST DR STE 300
Second Line :
City : TAMPA
State : FL
Zip : 33634-6327
Country : US
Telephone Number : 727-824-0780
Fax Number : 813-514-8891
Provider Business Practice Location Address
First Line : 5130 SUNFOREST DR STE 300
Second Line :
City : TAMPA
State : FL
Zip : 33634-6327
Country : US
Telephone Number : 727-824-0780
Fax Number : 813-514-8891
Authorized Official
Title or Position : SVP OF INTEGRATION & TRANSFORMATION
Name : LAURENE ANN DOUGHERTY
Credential :
Telephone Number : 727-828-2322
Provider Enumeration Date : 02/08/2006
Last Update Date : 05/17/2022

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Directions to “OPTUMCARE FLORIDA LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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