Organization Active NPI

Optimum Medical and Aesthetic Care LLC

  • Primary Care Clinic/Center
  • Plantation, FL
National Provider Identifier
1922984079
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
OPTIMUM MEDICAL AND AESTHETIC CARE LLC
Practice address
7500 NW 5TH St Ste 105
Plantation, FL 33317-1612
Phone
(754) 243-7774
NPI assigned
Aug 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Suzette MarseilleNPI 1215643358
Title
Aprn
Phone
(954) 709-4691

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
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

7500 NW 5TH St Ste 105
Plantation, FL 33317-1612

Mailing address

7500 NW 5TH St Ste 105
Plantation, FL 33317-1612
Phone (754) 243-7774

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250827000114 FL Part B Supplier - Clinic/Group Practice 2567962145 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, 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
10D2330259Optimum Medical and Aesthetic Care7500 NW 5TH Street Suite 105, Plantation, FL 33317Certificate of waiverSep 11, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1755129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1922984079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 NW 5TH ST STE 105",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333171612",
            "telephone_number": "754-243-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 NW 5TH ST STE 105",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333171612",
            "telephone_number": "754-243-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM MEDICAL AND AESTHETIC CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-14",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-13",
        "status": "A",
        "authorized_official_last_name": "MARSEILLE",
        "authorized_official_first_name": "SUZETTE",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "954-709-4691"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.