| Optimum Care Medical Group | |
|
3908 Sw 137th Ave Davie FL 33330-5712 | |
| (786) 470-0024 | |
| (954) 806-2484 |
| Full Name | Optimum Care Medical Group |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 3908 Sw 137th Ave, Davie, Florida |
| Authorized Official Name and Position | Ronoel Penalver (PHYSICIAN/OWNER) |
| Authorized Official Contact | 7864700024 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimum Care Medical Group 10312 Bloomingdale Ave Ste 108 Pmb 339 Riverview FL 33578-3603 Ph: (786) 470-0024 | Optimum Care Medical Group 3908 Sw 137th Ave Davie FL 33330-5712 Ph: (786) 470-0024 |
| NPI Number | 1962053728 |
|---|---|
| Provider Enumeration Date | 09/24/2019 |
| Last Update Date | 11/22/2022 |
| Medicare PECOS PAC ID | 2365875986 |
|---|---|
| Medicare Enrollment ID | O20191211002575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962053728 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 282N00000X | General Acute Care Hospital | (* (Not Available)) | Primary |
| Provider Name | Ronoel Penalver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083054324 PECOS PAC ID: 3870726623 Enrollment ID: I20160809000690 |
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