Provider Demographics
NPI:1235828476
Name:OPTIMAL VERSATILITY
Entity Type:Organization
Organization Name:OPTIMAL VERSATILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-954-2639
Mailing Address - Street 1:601 HERITAGE DR STE 207
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-2777
Mailing Address - Country:US
Mailing Address - Phone:561-954-2639
Mailing Address - Fax:
Practice Address - Street 1:601 HERITAGE DR STE 207
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-2777
Practice Address - Country:US
Practice Address - Phone:561-954-2639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies