Provider Demographics
NPI:1003159708
Name:MEDICAL CHOICE CENTER INC
Entity Type:Organization
Organization Name:MEDICAL CHOICE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-536-6135
Mailing Address - Street 1:2021 W 62ND ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2678
Mailing Address - Country:US
Mailing Address - Phone:786-536-6135
Mailing Address - Fax:786-536-6173
Practice Address - Street 1:2021 W 62ND ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2678
Practice Address - Country:US
Practice Address - Phone:786-536-6135
Practice Address - Fax:786-536-6173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy