MEDICARE: OPTIMUM LIFE HEALTH CENTER 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	111N00000X	Chiropractor	CH11267	FL

General Provider Information

NPI Number	:	1386173615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM LIFE HEALTH CENTER LLC

Provider Business Mailing Address
First Line	:	1800 W WOOLBRIGHT RD STE 101
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-6398
Country	:	US
Telephone Number	:	561-572-3542
Fax Number	:

Provider Business Practice Location Address
First Line	:	15280 S JOG RD STE D
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-2169
Country	:	US
Telephone Number	:	561-223-8266
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HAASSEEM MOHAMMED
Credential	:	DC
Telephone Number	:	561-223-8266

Provider Enumeration Date	:	06/09/2017
Last Update Date	:	06/14/2024

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Directions to “OPTIMUM LIFE HEALTH CENTER LLC ” Practice Location

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