Provider Demographics
NPI:1538157813
Name:OPTIMUS MEDICAL, INC.
Entity type:Organization
Organization Name:OPTIMUS MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:POZAS - NET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-984-0036
Mailing Address - Street 1:PO BOX 34412
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00734-4412
Mailing Address - Country:US
Mailing Address - Phone:787-984-0036
Mailing Address - Fax:787-984-0036
Practice Address - Street 1:842 CALLE CAMPECHE
Practice Address - Street 2:SUITE 102
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1672
Practice Address - Country:US
Practice Address - Phone:787-984-0036
Practice Address - Fax:787-984-0036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR005165332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR991469OtherMMM HEALTHCARE
PR55276OPOtherTRIPLE S
PRX0039OtherCRUZ AZUL DE PR
PR1266900001Medicare NSC