Provider Demographics
NPI:1265834881
Name:CARE OPTIMUM FAMILY HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:CARE OPTIMUM FAMILY HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY MEDICINE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-262-9007
Mailing Address - Street 1:4651 SHERIDAN ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3457
Mailing Address - Country:US
Mailing Address - Phone:754-210-7919
Mailing Address - Fax:754-210-7918
Practice Address - Street 1:4651 SHERIDAN ST
Practice Address - Street 2:SUITE 250
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3457
Practice Address - Country:US
Practice Address - Phone:754-210-7919
Practice Address - Fax:754-210-7918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME114969207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009141400Medicaid
FLHJ886ZOtherMEDICARE