MEDICARE: OPTIMAL HEALTH PHARMACY OF SISTRUNK 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	333600000X	Pharmacy

General Provider Information

NPI Number	:	1912857319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMAL HEALTH PHARMACY OF SISTRUNK LLC

Provider Business Mailing Address
First Line	:	17235 NW 27TH AVE
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-4418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1409 SISTRUNK BLVD.
Second Line	:	105
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311
Country	:	US
Telephone Number	:	305-705-4024
Fax Number	:	786-758-2005

Authorized Official
Title or Position	:	OWNER/PHARMACIST IN CHARGE
Name	:	KRISTEN DENISE HARRIS
Credential	:	PHARM D
Telephone Number	:	305-705-4024

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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