Provider Demographics
NPI:1063562767
Name:OPTIMUM PERFORMANCE TRAINING INC.
Entity type:Organization
Organization Name:OPTIMUM PERFORMANCE TRAINING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:LANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-342-0454
Mailing Address - Street 1:325 CATTLEMEN RD
Mailing Address - Street 2:UNIT B
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6312
Mailing Address - Country:US
Mailing Address - Phone:941-342-0454
Mailing Address - Fax:941-342-0272
Practice Address - Street 1:325 CATTLEMEN RD
Practice Address - Street 2:UNIT B
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-6312
Practice Address - Country:US
Practice Address - Phone:941-342-0454
Practice Address - Fax:941-342-0272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization