Provider Demographics
NPI:1871941195
Name:OPTIONONE MEDICAL CENTERS, LLC
Entity type:Organization
Organization Name:OPTIONONE MEDICAL CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-636-1269
Mailing Address - Street 1:1806 N FLAMINGO RD
Mailing Address - Street 2:STE 285
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1026
Mailing Address - Country:US
Mailing Address - Phone:954-636-1269
Mailing Address - Fax:954-252-8942
Practice Address - Street 1:1806 N FLAMINGO RD
Practice Address - Street 2:STE 285
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1026
Practice Address - Country:US
Practice Address - Phone:954-636-1269
Practice Address - Fax:954-252-8942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty