Provider Demographics
NPI:1427591841
Name:OPTIMUM HEALTH CARE SOLUTIONS
Entity type:Organization
Organization Name:OPTIMUM HEALTH CARE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:COHN-MANNINO
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:215-527-5094
Mailing Address - Street 1:PO BOX 3195
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33465-3195
Mailing Address - Country:US
Mailing Address - Phone:215-527-5094
Mailing Address - Fax:
Practice Address - Street 1:3589 S OCEAN BLVD
Practice Address - Street 2:#107
Practice Address - City:SOUTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-5753
Practice Address - Country:US
Practice Address - Phone:215-527-5094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9108830363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty