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General NPI Number Information
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NPI Number | 1710557699
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Entity Type | Organization
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Legal Business Name | AMERICA CHOICE FAMILY CLINIC AND BEHAVIOR HEALTH
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 10/13/2021
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Provider Practice Location Address
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Address Line | 15701 STATE ROAD 50 STE 204
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City | CLERMONT
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State | FL
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Zip | 34711-9203
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Country | US
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Telephone | 239-245-1698
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Fax |
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Provider Business Mailing Address
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Address Line | 11352 SW WYNDHAM WAY
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34987-2784
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Country | US
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Telephone | 239-245-1698
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | SCOTT MENARD
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Credential |
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Telephone | 239-245-1698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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