Provider Demographics
NPI:1346689932
Name:OPTIMAL HEALTH CHOICE LLC
Entity Type:Organization
Organization Name:OPTIMAL HEALTH CHOICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ORELUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-557-5052
Mailing Address - Street 1:7721 N MILITARY TRL
Mailing Address - Street 2:SUTIE 1-2
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410-7429
Mailing Address - Country:US
Mailing Address - Phone:561-557-5052
Mailing Address - Fax:
Practice Address - Street 1:7721 N MILITARY TRL
Practice Address - Street 2:SUTIE 1-2
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7429
Practice Address - Country:US
Practice Address - Phone:561-557-5052
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME112654207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008187100Medicaid
FLME112654OtherMEDICAL LICENSE
FLME112654OtherMEDICAL LICENSE