Optimum Care Medical Group

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

Legal business name

OPTIMUM CARE MEDICAL GROUP

Practice address

3908 SW 137TH Ave
Davie, FL 33330-5712

Phone

(786) 470-0024

Fax

(954) 806-2484

NPI assigned

Sep 24, 2019

Organization subpart

No

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

Authorized official

Name

Ronoel Penalver, MD

Title

Physician/Owner

Phone

(786) 470-0024

Specialties & licenses 2

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1962053728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10312 BLOOMINGDALE AVE",
            "address_2": "STE 108 PMB 339",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335783603",
            "telephone_number": "786-470-0024",
            "fax_number": "786-652-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 SW 137TH AVE",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333305712",
            "telephone_number": "786-470-0024",
            "fax_number": "954-806-2484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM CARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "PENALVER",
        "authorized_official_first_name": "RONOEL",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "786-470-0024",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Riverview",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10520 Alcon Blue Dr",
            "city": "Riverview",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335784116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; 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.