NPIMap

Organization Active NPI

Optimum Rehab, Inc.

  • Clinic/Center
  • Lake Mary, FL
National Provider Identifier
1285788083
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
OPTIMUM REHAB, INC.
Practice address
1061 S Sun Dr Ste 1089
Lake Mary, FL 32746-6169
Phone
(407) 323-6955
Fax
(855) 306-2974
NPI assigned
Jan 22, 2007
Last updated
Nov 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Fabian Ruiz
Title
President
Phone
(407) 323-6955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

1061 S Sun Dr Ste 1089
Lake Mary, FL 32746-6169

Mailing address

1061 S Sun Dr Ste 1089
Lake Mary, FL 32746-6169
Phone (407) 323-6955

Other identifiers 1

IdentifierTypeStateIssuer
015720500MedicaidFL

National Provider Directory

National Provider Directory

Locations

1061 S Sun Dr
Ste 1089
Lake Mary, FL 32746
Phone (407) 203-2369

145 Middle St
Ste 1101
Lake Mary, FL 32746
Phone (407) 323-6955

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1285788083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 S SUN DR STE 1089",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466169",
            "telephone_number": "407-323-6955",
            "fax_number": "855-306-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 S SUN DR STE 1089",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466169",
            "telephone_number": "407-323-6955",
            "fax_number": "855-306-2974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM REHAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "RUIZ",
        "authorized_official_first_name": "FABIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-323-6955"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015720500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.