Provider Demographics
NPI:1164664744
Name:OPTIMAL BEING INC.
Entity Type:Organization
Organization Name:OPTIMAL BEING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:AP, DOM
Authorized Official - Phone:407-701-7841
Mailing Address - Street 1:143 EASTERN FORK
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750
Mailing Address - Country:US
Mailing Address - Phone:407-701-7841
Mailing Address - Fax:407-332-1206
Practice Address - Street 1:499 E. CENTRAL PKWY. STE. 215
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701
Practice Address - Country:US
Practice Address - Phone:407-701-7841
Practice Address - Fax:407-332-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1781171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty