MEDICARE: OPTIMUM HEALTH & WELLNESS, 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1417675687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM HEALTH & WELLNESS, LLC

Provider Business Mailing Address
First Line	:	23031 TABAK LN
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-5230
Country	:	US
Telephone Number	:	813-856-1515
Fax Number	:	813-336-8922

Provider Business Practice Location Address
First Line	:	23031 TABAK LN
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-5230
Country	:	US
Telephone Number	:	813-856-1515
Fax Number	:	813-336-8922

Authorized Official
Title or Position	:	OWNER
Name	:	HEATHER HUGHES
Credential	:	APRN
Telephone Number	:	813-856-1515

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	06/03/2026

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