Provider Demographics
NPI:1780905117
Name:OPTIMAL HEALTH DR CHRISTOPHER D OLENEK LLC
Entity type:Organization
Organization Name:OPTIMAL HEALTH DR CHRISTOPHER D OLENEK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:OLENEK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:772-559-2444
Mailing Address - Street 1:960 37TH PL
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6586
Mailing Address - Country:US
Mailing Address - Phone:772-559-2444
Mailing Address - Fax:772-581-8490
Practice Address - Street 1:960 37TH PL
Practice Address - Street 2:SUITE 102
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6586
Practice Address - Country:US
Practice Address - Phone:772-559-2444
Practice Address - Fax:772-581-8490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL51488OtherBLUE CROSS BLUE SHIELD