MEDICARE: OPTIMUM CV PLLC

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1720863392
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMUM CV PLLC

Provider Business Mailing Address
First Line	:	12211 REGENCY VILLAGE DR STE 9
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32821-7813
Country	:	US
Telephone Number	:	904-257-3886
Fax Number	:	904-643-3881

Provider Business Practice Location Address
First Line	:	12211 REGENCY VILLAGE DR STE 9
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32821-7813
Country	:	US
Telephone Number	:	904-257-3886
Fax Number	:	904-643-3881

Authorized Official
Title or Position	:	OWNER/MD
Name	:	CARLOS RAFAEL ZAMORA
Credential	:
Telephone Number	:	786-879-9126

Provider Enumeration Date	:	08/30/2023
Last Update Date	:	01/15/2026

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