Graduated: 1981
NPI: 1922100346
Practice Locations (2)
OPTUMCARE FLORIDA, LLC
461 W OAK ST A, OPTUM KISSIMMEE
KISSIMMEE, FL 347416624
4078468600
WELLMED MEDICAL MANAGEMENT OF FLORIDA INC
960 58TH ST N, WELLMED AT TYRONE GARDENS
ST. PETERSBURG, FL 337106325
7278207778
Source: CMS National Downloadable File, September 2026.