MEDICARE: OPTIMA HOME HEALTH INC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1952597692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPTIMA HOME HEALTH INC

Provider Business Mailing Address
First Line	:	6911 PISTOL RANGE RD
Second Line	:	SUITE 103
City	:	TAMPA
State	:	FL
Zip	:	33635-6335
Country	:	US
Telephone Number	:	813-814-5970
Fax Number	:

Provider Business Practice Location Address
First Line	:	6911 PISTOL RANGE RD
Second Line	:	SUITE 103
City	:	TAMPA
State	:	FL
Zip	:	33635-6335
Country	:	US
Telephone Number	:	813-814-5970
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JOHN PRABHAKARAN
Credential	:
Telephone Number	:	727-643-8463

Provider Enumeration Date	:	09/17/2007
Last Update Date	:	07/08/2014

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Directions to “OPTIMA HOME HEALTH INC ” Practice Location

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