Organization Active NPI

Optimum Health System LLC

  • Family Medicine Physician
  • Coral Gables, FL
National Provider Identifier
1366226144
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
OPTIMUM HEALTH SYSTEM LLC
Practice address
3990 W Flagler St Ste 407
Coral Gables, FL 33134-1644
Phone
(305) 456-3879
NPI assigned
Aug 22, 2023
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
Milenis Lopez LeonNPI 1417537010
Title
Owner
Phone
(786) 343-8781

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

3990 W Flagler St Ste 407
Coral Gables, FL 33134-1644

Mailing address

3990 W Flagler St Ste 407
Coral Gables, FL 33134-1644

Other practice location 1

3970 W Flagler St Ste 201
Coral Gables, FL 33134-1642
Phone (786) 343-8781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231004004182 FL Part B Supplier - Clinic/Group Practice 4183079528 Receives reassigned benefits from 2 practitioners
Practice locations: Coral Gables, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2297830Optimum Health System LLC3990 W Flagler St, Ste 407, Miami, FL 33134Certificate of waiverJan 22, 2028

National Provider Directory

National Provider Directory

Locations

3970 W Flagler St
Ste 201
Coral Gables, FL 33134
Phone (305) 774-6186

3990 W Flagler St
Ste 407
Coral Gables, FL 33134
Phone (305) 445-8125

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1366226144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3990 W FLAGLER ST STE 407",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331341644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3990 W FLAGLER ST STE 407",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331341644",
            "telephone_number": "305-456-3879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3970 W Flagler St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331341642",
            "country_code": "US",
            "telephone_number": "786-343-8781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTIMUM HEALTH SYSTEM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-22",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "LOPEZ LEON",
        "authorized_official_first_name": "MILENIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-343-8781"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.