Provider Demographics
NPI:1114799095
Name:OPTIMUM HEALTH INC
Entity Type:Organization
Organization Name:OPTIMUM HEALTH INC
Other - Org Name:OPTIMUM HEALTH NATUROPATHIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:BOAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:787-619-0540
Mailing Address - Street 1:1 AVE LAGUNA APT 8A
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-6535
Mailing Address - Country:US
Mailing Address - Phone:787-619-0540
Mailing Address - Fax:
Practice Address - Street 1:59 AVE ESMERALDA
Practice Address - Street 2:
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-4429
Practice Address - Country:US
Practice Address - Phone:787-720-3234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty