Provider Demographics
NPI:1629456314
Name:OPTIMUM HEALTH MEDICAL CARE, PLLC
Entity type:Organization
Organization Name:OPTIMUM HEALTH MEDICAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAFEESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-766-3000
Mailing Address - Street 1:10524 MOSS PARK RD
Mailing Address - Street 2:SUITE 204-187
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5898
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10524 MOSS PARK RD
Practice Address - Street 2:SUITE 204-187
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5898
Practice Address - Country:US
Practice Address - Phone:407-629-1599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care