Provider Demographics
NPI:1942900816
Name:OPTIMUS HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:OPTIMUS HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC AND FAMILY HEALTH NURSE
Authorized Official - Prefix:
Authorized Official - First Name:WILMOT
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:347-728-6880
Mailing Address - Street 1:2299 SUMMER ST # 1087
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-4502
Mailing Address - Country:US
Mailing Address - Phone:347-728-6880
Mailing Address - Fax:
Practice Address - Street 1:26229 RAPHAEL DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355
Practice Address - Country:US
Practice Address - Phone:347-728-6880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty