MEDICARE: OPULENT MANAGEMENT CONSULTING GROUP 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1376406835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPULENT MANAGEMENT CONSULTING GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 4184
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33918-4184
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 DR MARTIN LUTHER KING BLVD STE C
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3669
Country	:	US
Telephone Number	:	727-502-7380
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	LOUISIANE JONES
Credential	:
Telephone Number	:	727-502-7380

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/03/2025

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