Optumcare Florida LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH19244 Issued in FL

Legal business name

OPTUMCARE FLORIDA LLC

Practice address

7601 9TH St N
Ste C 1
St Petersburg, FL 33702-5211

Phone

(727) 520-7995

Fax

(727) 520-7963

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

John G. Liethen

Title

Secretary

Phone

(952) 205-6262

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• DaVita Medical Group Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279

  Member Of

  NPD member

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1972663102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051 5TH STREET N.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "33702",
            "telephone_number": "727-520-7995",
            "fax_number": "727-520-7963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 9TH ST N",
            "address_2": "STE C 1",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337025211",
            "telephone_number": "727-520-7995",
            "fax_number": "727-520-7963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUMCARE FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "LIETHEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "952-205-6262"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH19244",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030938900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2015674",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Optimized Therapy Transitions, LLC
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• Options Medical Clinical, P.a.
• Optum Behavioral Care of North Carolina, P.C.
• Ana C Oquendo, MD
• Juan Luis Oquendo, RPH
• Oral Surgery Centers of America, LLC
• Orion Medical Equipments LLC
• Orion T. Ayer Jr. MD PA

• Community/Retail Pharmacy in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.