Provider Demographics
NPI:1902642283
Name:OPTIMA INFUSION PHARMACY INC
Entity type:Organization
Organization Name:OPTIMA INFUSION PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIELY
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MHA, CSP
Authorized Official - Phone:787-883-5959
Mailing Address - Street 1:HC 3 BOX 7525
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-9539
Mailing Address - Country:US
Mailing Address - Phone:787-883-5959
Mailing Address - Fax:787-883-6040
Practice Address - Street 1:CARR 2 KM 26.2 ESPINOSA
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-9539
Practice Address - Country:US
Practice Address - Phone:787-883-5959
Practice Address - Fax:787-883-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy