Provider Demographics
NPI:1639788680
Name:OPTIMAL FAMILY CARE & AESTHETICS
Entity Type:Organization
Organization Name:OPTIMAL FAMILY CARE & AESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP/FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:EGLANTE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-901-3779
Mailing Address - Street 1:11419 W PALMETTO PARK RD UNIT 970032
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33497-2503
Mailing Address - Country:US
Mailing Address - Phone:954-933-7164
Mailing Address - Fax:954-933-1986
Practice Address - Street 1:2001 N FEDERAL HWY UNIT 219
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1039
Practice Address - Country:US
Practice Address - Phone:954-933-7164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty