MEDICARE: DR. JOHN M CHOI D.O.

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	2086S0122X	Plastic and Reconstructive Surgery Physician	OS-8298	FL

General Provider Information

NPI Number	:	1720151517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN M CHOI D.O.

Provider Business Mailing Address
First Line	:	7425 CONROY WINDERMERE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-2758
Country	:	US
Telephone Number	:	407-299-7575
Fax Number	:	407-299-0957

Provider Business Practice Location Address
First Line	:	7425 CONROY WINDERMERE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32835-2758
Country	:	US
Telephone Number	:	407-299-7575
Fax Number	:	407-299-0957

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2006
Last Update Date	:	07/08/2007

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