Optimal Health & Wellness Florida LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

OPTIMAL HEALTH & WELLNESS FLORIDA LLC

Practice address

830 N Krome Ave
Homestead, FL 33030-4407

Phone

(305) 417-6377

NPI assigned

Aug 18, 2020

Organization subpart

No

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

Authorized official

Name

Ted Groesbeck

Title

Ceo

Phone

(305) 417-6377

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617321600000",
    "number": "1760094106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 N KROME AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304407",
            "telephone_number": "305-417-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 N KROME AVE",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330304407",
            "telephone_number": "305-417-6377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "427 Biltmore Way Ste 107",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "331345735",
            "country_code": "US",
            "telephone_number": "305-417-6377",
            "fax_number": "786-723-6820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTIMAL HEALTH & WELLNESS FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-18",
        "last_updated": "2021-04-02",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "GROESBECK",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-417-6377"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.