Provider Demographics
NPI:1912018573
Name:OPTIMA HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:OPTIMA HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:RONAY
Authorized Official - Middle Name:LUE
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:941-747-1585
Mailing Address - Street 1:707 60TH STREET CT E
Mailing Address - Street 2:SUITE A
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-6279
Mailing Address - Country:US
Mailing Address - Phone:941-747-1585
Mailing Address - Fax:941-745-1387
Practice Address - Street 1:707 60TH STREET CT E
Practice Address - Street 2:SUITE A
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-6279
Practice Address - Country:US
Practice Address - Phone:941-747-1585
Practice Address - Fax:941-745-1387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8677Medicare ID - Type UnspecifiedMASS IMMUNIZATION PROVIDE