# OPTUMCARE SOUTH FLORIDA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Optum
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437434735
- **Authorized official:** JOHN G. LIETHEN (SECRETARY)
- **Authorized official phone:** (952) 205-6262

## Contact information

- **Practice address:** 5130 SUNFOREST DR STE 300, TAMPA, FL 33634-6327
- **Practice address phone:** (727) 824-0780
- **Practice address fax:** (813) 514-8891
- **Mailing address:** 5130 SUNFOREST DR STE 300, TAMPA, FL 33634-6327
- **Mailing address phone:** (727) 824-0780
- **Mailing address fax:** (813) 514-8891

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/18/2011
- **Last updated:** 11/24/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004371300 | — | FL |