MEDICARE: OPTIMAL HEALTH CHOICE 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	207R00000X	Internal Medicine Physician	ME112654	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	ME112654	OTHER	FL	MEDICAL LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346689932
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMAL HEALTH CHOICE LLC

Provider Business Mailing Address
First Line	:	7721 N MILITARY TRL
Second Line	:	SUTIE 1-2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-7429
Country	:	US
Telephone Number	:	561-557-5052
Fax Number	:

Provider Business Practice Location Address
First Line	:	7721 N MILITARY TRL
Second Line	:	SUTIE 1-2
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-7429
Country	:	US
Telephone Number	:	561-557-5052
Fax Number	:

Authorized Official
Title or Position	:	MD
Name	:	DR. EMMANUEL ORELUS
Credential	:	M.D.
Telephone Number	:	561-557-5052

Provider Enumeration Date	:	06/18/2013
Last Update Date	:	01/21/2014

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Directions to “OPTIMAL HEALTH CHOICE LLC ” Practice Location

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