MEDICARE: OPTIMIZE REHABILITATION

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	261QX0100X	Occupational Medicine Clinic/Center
2	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1437717212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMIZE REHABILITATION

Provider Business Mailing Address
First Line	:	1613 SE 7TH ST
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-5813
Country	:	US
Telephone Number	:	484-894-3207
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 SE 7TH ST
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-5813
Country	:	US
Telephone Number	:	484-894-3207
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JUSTIN BLOCKI
Credential	:	OTR/L
Telephone Number	:	484-894-3207

Provider Enumeration Date	:	06/05/2019
Last Update Date	:	07/16/2020

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