Provider Demographics
NPI:1750814505
Name:OPTIMAL CARE CENTER
Entity type:Organization
Organization Name:OPTIMAL CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GURAMAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BHULLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:786-452-9095
Mailing Address - Street 1:PO BOX 402692
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-0692
Mailing Address - Country:US
Mailing Address - Phone:786-452-9095
Mailing Address - Fax:
Practice Address - Street 1:3850 SW 87TH AVE
Practice Address - Street 2:205
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-5400
Practice Address - Country:US
Practice Address - Phone:786-452-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-09
Last Update Date:2017-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty