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Organization
OPTUMUMHEALTHOUTCOMES
Active
Organization
OPTUMUMHEALTHOUTCOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY EDWARDS (EXECUTIVE DIRECTOR)
(407) 394-7181
Entity
Organization
Contact information
Practice address
5104 N ORANGE BLOSSOM TRL, SUITE 108, ORLANDO, FL 32810-1042
(407) 394-7181
(810) 222-6666
Mailing address
4531 ARCH ST, ORLANDO, FL 32808-7805
(407) 394-7181
(810) 222-6666
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
NULL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109752000
—
FL
Enumeration date
02/16/2014
Last updated
09/22/2021
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