Provider Demographics
NPI:1407390446
Name:FIRST CHOICE MAITLAND, PLLC
Entity Type:Organization
Organization Name:FIRST CHOICE MAITLAND, PLLC
Other - Org Name:FIRST CHOICE URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HARBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-366-2890
Mailing Address - Street 1:1945 WEST COUNTY ROAD 419
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32766
Mailing Address - Country:US
Mailing Address - Phone:407-366-2890
Mailing Address - Fax:407-366-2843
Practice Address - Street 1:110 NORTH ORLANDO AVENUE
Practice Address - Street 2:SUITE 14
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-335-4045
Practice Address - Fax:407-335-4279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-09
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care