Organization Active NPI

Optimal Living Center

  • Community/Behavioral Health Agency
  • Miami, FL
National Provider Identifier
1518347699
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
PY7105 Issued in FL
Legal business name
OPTIMAL LIVING CENTER
Practice address
9425 SW 72ND St Ste 267
Miami, FL 33173-5457
Phone
(305) 981-6806
NPI assigned
Jun 4, 2015
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

Name
Dr. Jose Bermudez, PSYDNPI 1629466958
Title
Psychologist
Phone
(305) 981-6806

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
Community/Behavioral Health Agency 251S00000X PY7105 FL Primary

Addresses

Primary practice location

9425 SW 72ND St Ste 267
Miami, FL 33173-5457

Mailing address

9425 SW 72ND St Ste 267
Miami, FL 33173-5457
Phone (305) 981-6806

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240514002116 FL Part B Supplier - Clinic/Group Practice 5294176889 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL

National Provider Directory

National Provider Directory

Locations

7385 SW 87th Ave
Ste 100
Miami, FL 33173
Phone (786) 269-6638

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1433376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1518347699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9425 SW 72ND ST STE 267",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331735457",
            "telephone_number": "305-981-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9425 SW 72ND ST STE 267",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331735457",
            "telephone_number": "305-981-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL LIVING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-04",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "BERMUDEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "305-981-6806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "PY7105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.