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General NPI Number Information
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NPI Number | 1215232426
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Entity Type | Organization
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Legal Business Name | FAMILY CHOICE MEDICAL CLINIC PA
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Dates
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Enumeration Date | 01/19/2011
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Last Update Date | 02/22/2011
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Provider Practice Location Address
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Address Line | 4698 FOREST HILL BLVD SUITE B
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City | WEST PALM BEACH
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State | FL
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Zip | 33415-5719
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Country | US
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Telephone | 410-852-5138
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Fax | 561-247-7792
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Provider Business Mailing Address
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Address Line | 14834 HORSESHOE TRCE
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City | WELLINGTON
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State | FL
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Zip | 33414-4032
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Country | US
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Telephone | 410-852-5138
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Fax | 561-247-7792
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHINYERE CHRIS MBAERI
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Credential | M.D.
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Telephone | 410-852-5138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME101902
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License Number State | FL
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