MEDICARE: FIRST CHOICE HEALTH & PROVIDERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1154157709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHOICE HEALTH & PROVIDERS, LLC

Provider Business Mailing Address
First Line	:	76 4TH ST N STE 541
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-3828
Country	:	US
Telephone Number	:	813-614-7232
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 4TH ST N STE 541
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-3828
Country	:	US
Telephone Number	:	813-614-7232
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MARIE JUDENIA GIORDANI
Credential	:
Telephone Number	:	813-614-7232

Provider Enumeration Date	:	09/10/2024
Last Update Date	:	09/10/2024

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