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General NPI Number Information
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NPI Number | 1023200912
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE HEALTH CENTER, INC.
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 08/14/2007
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Provider Practice Location Address
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Address Line | 448 E 9TH ST
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City | HIALEAH
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State | FL
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Zip | 33010-4548
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Country | US
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Telephone | 786-517-1912
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Fax | 786-517-1910
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Provider Business Mailing Address
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Address Line | 448 E 9TH ST
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City | HIALEAH
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State | FL
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Zip | 33010-4548
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Country | US
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Telephone | 786-517-1912
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Fax | 786-517-1910
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | ADRIAN DIAZ
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Credential | LMT
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Telephone | 786-517-1912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | HCC5289
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License Number State | FL
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