Provider Demographics
NPI:1306371513
Name:OPTIMUM POINT OF CARE PHYSICIANS GROUP, LLC
Entity Type:Organization
Organization Name:OPTIMUM POINT OF CARE PHYSICIANS GROUP, LLC
Other - Org Name:OPTIMUM POINT OF CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARAI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-345-1943
Mailing Address - Street 1:3904 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3111
Mailing Address - Country:US
Mailing Address - Phone:941-345-1943
Mailing Address - Fax:941-345-1944
Practice Address - Street 1:3904 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3111
Practice Address - Country:US
Practice Address - Phone:941-345-1943
Practice Address - Fax:941-345-1944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80769207R00000X, 207RG0300X
FLME82566207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty