Organization
OPTUMCARE MANAGEMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN G. LIETHEN (SECRETARY)
(952) 205-6262
Entity
Organization
Contact information
Practice address
3150 W PROSPECT RD, SUITE 320, FORT LAUDERDALE, FL 33309-2597
(954) 677-1011
(954) 677-0922
Mailing address
3150 W PROSPECT RD, SUITE 320, FORT LAUDERDALE, FL 33309-2597
(954) 677-1011
(954) 677-0922
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1312625
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1312625
HME LICENSE
FL
Enumeration date
07/20/2005
Last updated
08/20/2019
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