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NPI Code Detail

MEDICARE: OPTIMUM HEALTHCARE INC.

MEDICARE: OPTIMUM HEALTHCARE 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
1302R00000XHealth Maintenance Organization87098FL

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 : 1316318363
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPTIMUM HEALTHCARE INC.
Provider Business Mailing Address
First Line : 5403 N CHURCH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-5611
Country : US
Telephone Number : 813-506-6000
Fax Number : 888-548-0091
Provider Business Practice Location Address
First Line : 5403 N CHURCH AVE
Second Line :
City : TAMPA
State : FL
Zip : 33614-5611
Country : US
Telephone Number : 813-506-6000
Fax Number : 888-548-0091
Authorized Official
Title or Position : PRESIDENT
Name : DR. KIRAN PATEL
Credential : M.D.
Telephone Number : 813-506-6000
Provider Enumeration Date : 10/16/2015
Last Update Date : 10/16/2015

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Directions to “OPTIMUM HEALTHCARE INC. ” Practice Location

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