MEDICARE: OPTIMUM STAFFING SERVICES 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1124890439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM STAFFING SERVICES LLC

Provider Business Mailing Address
First Line	:	7901 SW 6TH CT RM 302
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3282
Country	:	US
Telephone Number	:	813-655-4949
Fax Number	:	813-359-9270

Provider Business Practice Location Address
First Line	:	7901 SW 6TH CT FL 3
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-3282
Country	:	US
Telephone Number	:	813-655-4949
Fax Number	:	813-359-9270

Authorized Official
Title or Position	:	MANAGER
Name	:	GLADYS KANODEREKA
Credential	:
Telephone Number	:	813-655-4949

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	11/07/2023

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