Provider Demographics
NPI:1043551344
Name:TEAM PHYSICIANS OF FLORIDA LLC
Entity Type:Organization
Organization Name:TEAM PHYSICIANS OF FLORIDA LLC
Other - Org Name:ACCIDENT & ANTI AGING CLINIC LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENOIT
Authorized Official - Middle Name:O
Authorized Official - Last Name:CHOINIERE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-488-8044
Mailing Address - Street 1:1501 S MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-2236
Mailing Address - Country:US
Mailing Address - Phone:727-488-8044
Mailing Address - Fax:
Practice Address - Street 1:1501 S MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-2236
Practice Address - Country:US
Practice Address - Phone:727-488-8044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-12
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10323111NN0400X
207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No111NN0400XChiropractic ProvidersChiropractorNeurologyGroup - Multi-Specialty