Provider Demographics
NPI:1164296570
Name:OPTIMUM STAFFING SERVICES LLC
Entity Type:Organization
Organization Name:OPTIMUM STAFFING SERVICES LLC
Other - Org Name:OPTIMUM HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:KANODEREKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-655-4949
Mailing Address - Street 1:2451 N MCMULLEN BOOTH RD FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1356
Mailing Address - Country:US
Mailing Address - Phone:813-330-8424
Mailing Address - Fax:813-359-9270
Practice Address - Street 1:2451 N MCMULLEN BOOTH RD FL 2
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1356
Practice Address - Country:US
Practice Address - Phone:813-330-8424
Practice Address - Fax:813-359-9270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health