SUD FACILITY OPTIMIZATION LLC NPI 1467193623

NPI Information

  • NPI: 1467193623
  • Provider Name: SUD FACILITY OPTIMIZATION, LLC
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • Doing Business As: SUD FAC OPT
  • Address: 1030 VENETIAN DR UNIT 202
    MELBOURNE, FL
    ZIP 32904
  • Phone: (954) 260-0104

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NPI Details

SUD FACILITY OPTIMIZATION, LLC is an internal medicine in Melbourne, FL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. SUD FACILITY OPTIMIZATION, LLC NPI is 1467193623. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Sud Fac Opt.

The provider's business location address is:

1030 VENETIAN DR UNIT 202
MELBOURNE, FL
ZIP 32904-466
Phone: (954) 260-0104

The provider's authorized official is Jay Bouldin .
The authorized official title is Research Director and has the following contact phone number (321) 989-2187.

The enumeration date for this NPI number is 4/4/2022 and was last updated on 8/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2200XNurse PractitionerAdult HealthNo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
3363LP2300XNurse PractitionerPrimary CareNo
4261QR1100XClinic/CenterResearchNo
5324500000XSubstance Abuse Rehabilitation FacilityNo
6363LA2100XNurse PractitionerAcute CareNo
7207QA0401XFamily MedicineAddiction MedicineNo
8207RA0401XInternal MedicineAddiction MedicineNo
92084A0401XPsychiatry & NeurologyAddiction MedicineNo
10261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
11163WA0400XRegistered NurseAddiction (Substance Use Disorder)No
12207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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