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General NPI Number Information
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NPI Number | 1679503627
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE FAMILY MEDICAL CENTER, PA
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 120 MEDICAL BLVD SUITE 102
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City | SPRING HILL
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State | FL
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Zip | 34609-0220
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Country | US
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Telephone | 352-686-0086
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Fax | 352-684-2081
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Provider Business Mailing Address
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Address Line | 120 MEDICAL BLVD SUITE 102
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City | SPRING HILL
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State | FL
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Zip | 34609-0221
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Country | US
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Telephone | 352-686-0086
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Fax | 352-684-2081
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN C KROLL
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Credential | D.O.
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Telephone | 352-686-0086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8257
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License Number State | FL
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