Provider Demographics
NPI:1083830988
Name:DOCTOR'S CHOICE MEDICAL, INC.
Entity Type:Organization
Organization Name:DOCTOR'S CHOICE MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:LCO, RPTA
Authorized Official - Phone:954-978-8600
Mailing Address - Street 1:9315 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4101
Mailing Address - Country:US
Mailing Address - Phone:954-978-8600
Mailing Address - Fax:954-978-8688
Practice Address - Street 1:3004 ALTONA, MEDICAL ARTS COMPLEX
Practice Address - Street 2:STE 16
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-777-2374
Practice Address - Fax:340-777-2369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLORT 121335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI1089010003Medicare NSC