Provider Demographics
NPI:1952597692
Name:OPTIMA HOME HEALTH INC
Entity type:Organization
Organization Name:OPTIMA HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PRABHAKARAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-643-8463
Mailing Address - Street 1:6911 PISTOL RANGE RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33635-6335
Mailing Address - Country:US
Mailing Address - Phone:813-814-5970
Mailing Address - Fax:
Practice Address - Street 1:6911 PISTOL RANGE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-6335
Practice Address - Country:US
Practice Address - Phone:813-814-5970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-17
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health