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General NPI Number Information
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NPI Number | 1902419187
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Entity Type | Organization
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Legal Business Name | SUPERIOR CHOICE PHYSICIANS INCORPORATED
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 2519 N MCMULLEN BOOTH RD STE 510-203
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City | CLEARWATER
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State | FL
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Zip | 33761-4173
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Country | US
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Telephone | 407-923-4205
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Fax |
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Provider Business Mailing Address
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Address Line | 2519 N MCMULLEN BOOTH RD STE 510-203
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City | CLEARWATER
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State | FL
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Zip | 33761-4173
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Country | US
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Telephone | 407-923-4205
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID DEJESUS
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Credential |
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Telephone | 817-751-1811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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