Healthcare Provider Details

I. General information

NPI: 1407390446
Provider Name (Legal Business Name): FIRST CHOICE MAITLAND, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2016
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NORTH ORLANDO AVENUE SUITE 14
MAITLAND FL
32751
US

IV. Provider business mailing address

1945 WEST COUNTY ROAD 419 SUITE 1101
OVIEDO FL
32766
US

V. Phone/Fax

Practice location:
  • Phone: 407-335-4045
  • Fax: 407-335-4279
Mailing address:
  • Phone: 407-366-2890
  • Fax: 407-366-2843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID HARBOUR
Title or Position: OWNER
Credential: D.O.
Phone: 407-366-2890