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Organization

OPTIMUM REHABILITATION SPECIALISTS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRENDAN MALIK MD (MD)
(330) 285-0592
Entity
Organization

Contact information

Practice address
2718 LEE BLVD #C, LEHIGH ACRES, FL 33971-1537
(239) 303-9100
(239) 303-9101
Mailing address
PO BOX 3576, APOLLO BEACH, FL 33572-1005
(330) 285-0592
(888) 803-9101

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT0009763
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
686674
MEDICARE PTAN
FL
01
RB6
BCBS FLORIDA
FL
01
RE1
BCBS
FL
Enumeration date
03/20/2006
Last updated
11/08/2020
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