Organization
OPTUMCARE FLORIDA, LLC
Active
Organization
OPTUMCARE FLORIDA, LLC
Active
Other names
Jsa Medical Group- Brandon, DaVita Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN G. LIETHEN (SECRETARY)
(952) 205-6262
Entity
Organization
Contact information
Practice address
1933 W LUMSDEN RD, BRANDON, FL 33511-8819
(813) 653-3111
Mailing address
10051 5TH STREET N., ST. PETERSBURG, FL 33702
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
ME66254
FL
Other
Enumeration date
09/03/2015
Last updated
08/19/2019
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up