OrganizationOptimal Jacksonville LlcRadiologyAllopathic & Osteopathic PhysiciansPractice Address6138 Kennerly Rd, Suite 101, Jacksonville, FL 32216-4393(904) 733-7770PECOS EnrollmentBased on the most recent information from CMS, provider Optimal Jacksonville Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1942604723Provider TypeOrganizationFull NameOptimal Jacksonville LlcSubpartNoEnumeration Date10/22/2014Last Updated10/22/2014Contact InformationPractice LocationPractice Address6138 Kennerly Rd, Suite 101, Jacksonville, FL 32216-4393Phone(904) 733-7770FaxUnlisted FaxMailing LocationMailing Address3803 Bedford Ave, #103, Nashville, TN 37215-2564Phone(904) 733-7770FaxUnlisted FaxAuthorized OfficialNameHaley, Jason Brett (Vp)Phone(616) 429-0957Provider TaxonomiesCodeDescriptionLicenseCode2085R0202XPrimaryDescriptionRadiologyAllopathic & Osteopathic PhysiciansLicenseUnlisted Issuer