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NPI Code Detail

MEDICARE: OPTIMUM REHAB, INC.

MEDICARE: OPTIMUM REHAB, INC.
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
1261Q00000XClinic/Center

Other Identifiers

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

General Provider Information

NPI Number : 1285788083
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTIMUM REHAB, INC.
Provider Business Mailing Address
First Line : 1061 S SUN DR STE 1089
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-6169
Country : US
Telephone Number : 407-323-6955
Fax Number : 855-306-2974
Provider Business Practice Location Address
First Line : 1061 S SUN DR STE 1089
Second Line :
City : LAKE MARY
State : FL
Zip : 32746-6169
Country : US
Telephone Number : 407-323-6955
Fax Number : 855-306-2974
Authorized Official
Title or Position : PRESIDENT
Name : FABIAN RUIZ
Credential :
Telephone Number : 407-323-6955
Provider Enumeration Date : 01/22/2007
Last Update Date : 11/15/2024

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