Provider Demographics
NPI:1326719519
Name:OPTIMUM CARE SWFL, INC
Entity Type:Organization
Organization Name:OPTIMUM CARE SWFL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-789-5897
Mailing Address - Street 1:2256 FIRST ST STE 103
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-2960
Mailing Address - Country:US
Mailing Address - Phone:239-202-2302
Mailing Address - Fax:321-655-7349
Practice Address - Street 1:2256 FIRST ST STE 103
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-2960
Practice Address - Country:US
Practice Address - Phone:239-202-2302
Practice Address - Fax:321-655-7349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health