Optumcare Florida, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH18603 Issued in FL

Legal business name

OPTUMCARE FLORIDA, LLC

Practice address

4757 US Highway 19
New Port Richey, FL 34652-4945

Phone

(727) 849-9373

Fax

(727) 841-0497

NPI assigned

Dec 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John G. Liethen

Title

Secretary

Phone

(952) 205-6262

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• JSA Healthcare Corporation Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1063572295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH STREET NORTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337022299",
            "telephone_number": "727-849-9373",
            "fax_number": "727-841-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4757 US HIGHWAY 19",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524945",
            "telephone_number": "727-849-9373",
            "fax_number": "727-841-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUMCARE FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "LIETHEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "952-205-6262"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH18603",
            "primary": true
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030843900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4399230001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2014572",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JSA Healthcare Corporation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "JSA Healthcare Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• On Time Transportation Solutions Corp 1
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• Operation Par Inc
• Optimal Patient Care LLC
• Optimum Family Care PA
• Optumcare Florida, LLC
• John P Opyoke, MD
• Yaquelin Orama, RBT
• Orange Grove Dental
• Dana Orlando, MS, SLP

• Community/Retail Pharmacy in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.