MEDICARE: OPTIMUM CARE SWFL, 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
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1326719519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM CARE SWFL, INC

Provider Business Mailing Address
First Line	:	2023 CANAL ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-6111
Country	:	US
Telephone Number	:	239-202-2302
Fax Number	:	321-655-7349

Provider Business Practice Location Address
First Line	:	2023 CANAL ST
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-6111
Country	:	US
Telephone Number	:	239-202-2302
Fax Number	:	321-655-7349

Authorized Official
Title or Position	:	ADMINISTRATOR/DON
Name	:	MELISSA MILIAN
Credential	:
Telephone Number	:	239-789-5897

Provider Enumeration Date	:	09/27/2021
Last Update Date	:	12/18/2024

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