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General NPI Number Information
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NPI Number | 1114260742
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Entity Type | Organization
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Legal Business Name | FIRST CLINIC CHOICE CORP
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Dates
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Enumeration Date | 04/02/2013
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Last Update Date | 04/02/2013
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Provider Practice Location Address
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Address Line | 900 W 49TH ST STE 505
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City | HIALEAH
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State | FL
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Zip | 33012-3402
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Country | US
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Telephone | 305-202-1270
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Fax | 305-202-1271
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Provider Business Mailing Address
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Address Line | 900 W 49TH ST STE 505
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City | HIALEAH
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State | FL
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Zip | 33012-3402
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Country | US
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Telephone | 305-202-1270
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Fax | 305-202-1271
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Authorized Official
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Title or Position | PRESIDENT
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Name | HUMBERTO MARTINEZ
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Credential |
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Telephone | 305-202-1270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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