| Optimus Care Physician Services Pllc | |
|
5475 Nw Saint James Dr # 148 Port St Lucie FL 34983-3444 | |
| (772) 678-9033 | |
| Not Available |
| Full Name | Optimus Care Physician Services Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5475 Nw Saint James Dr # 148, Port St Lucie, Florida |
| Authorized Official Name and Position | Magaly Rouzier (OWNER) |
| Authorized Official Contact | 7726789033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Optimus Care Physician Services Pllc 5475 Nw Saint James Dr # 148 Port St Lucie FL 34983-3444 Ph: () - | Optimus Care Physician Services Pllc 5475 Nw Saint James Dr # 148 Port St Lucie FL 34983-3444 Ph: (772) 678-9033 |
| NPI Number | 1184006892 |
|---|---|
| Provider Enumeration Date | 06/18/2015 |
| Last Update Date | 06/19/2015 |
| Medicare PECOS PAC ID | 0840505525 |
|---|---|
| Medicare Enrollment ID | O20150811004354 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184006892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME86524 (Florida) | Primary |
| Provider Name | Kathly M Jean- Gilles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700866068 PECOS PAC ID: 4880625714 Enrollment ID: I20051227000201 |
| Provider Name | Magaly R Rouzier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659366060 PECOS PAC ID: 4082607395 Enrollment ID: I20150811004411 |
| Provider Name | Kristin Trenham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578884326 PECOS PAC ID: 4082895925 Enrollment ID: I20160330001563 |
| Provider Name | Pete Decuir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912927781 PECOS PAC ID: 7719964931 Enrollment ID: I20161119000082 |
| Provider Name | Garry Desulme |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871143578 PECOS PAC ID: 6800203787 Enrollment ID: I20210319000705 |
| Provider Name | Altagrace Jean Baptiste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629682331 PECOS PAC ID: 9931517869 Enrollment ID: I20210414001389 |
| Provider Name | Paulard Bernard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578104816 PECOS PAC ID: 3476951492 Enrollment ID: I20211006000171 |
| Provider Name | Jennifer C Teitelbaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447915699 PECOS PAC ID: 9931595337 Enrollment ID: I20220412002345 |
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