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General NPI Number Information
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NPI Number | 1760825699
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Entity Type | Organization
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Legal Business Name | 1ST CHOICE URGENT CARE CENTER LLC
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 07/29/2024
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Provider Practice Location Address
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Address Line | 128 NW 137TH DRIVE
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City | NEWBERRY
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State | FL
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Zip | 32669
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Country | US
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Telephone | 352-332-1890
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Fax | 352-224-6465
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Provider Business Mailing Address
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Address Line | 10348 SW 32ND AVE
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City | GAINESVILLE
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State | FL
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Zip | 32608-9096
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Country | US
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Telephone | 352-317-3214
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN DISTEFANO
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Credential |
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Telephone | 352-317-3214
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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