FATIMA HEALTH LLC NPI 1710500962

NPI Information

NPI: 1710500962
Provider Name: FATIMA HEALTH LLC

Doing Business As: OPTIMAL HEALTH MEDICAL CLINIC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 03D2199324

Address:
855 E BROWN RD STE 10
MESA, AZ
ZIP 85203
Phone: (623) 910-3171
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FATIMA HEALTH LLC is a family nurse practitioner in Mesa, AZ. FATIMA HEALTH LLC NPI is 1710500962. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Optimal Health Medical Clinic.

The provider's business location address is:

855 E BROWN RD STE 10
MESA, AZ
ZIP 85203-949
Phone: (623) 910-3171
Fax: (949) 655-2754

The provider's authorized official is Lilian L Laimo .
The authorized official title is Owner and has the following contact phone number (623) 910-3171.

The CLIA number assigned to this NPI record is 03D2199324 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2020 and was last updated on 12/18/2020.

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
1	363LF0000X	Nurse Practitioner	Family			Yes

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: 4/28/2024

NPI Synchronization or Removal

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