Healthcare Provider Details

I. General information

NPI: 1265639298
Provider Name (Legal Business Name): MEDCHOICE HEATLH CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 NE 13TH AVE
NORTH MIAMI BEACH FL
33162-4608
US

IV. Provider business mailing address

8212 W FLAGLER ST
MIAMI FL
33144-2028
US

V. Phone/Fax

Practice location:
  • Phone: 305-944-1122
  • Fax: 305-944-1133
Mailing address:
  • Phone: 305-444-7799
  • Fax: 305-860-8255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. LOURDES M TIRADO
Title or Position: V.P. OPERATIONS
Credential:
Phone: 305-444-7799