Provider Demographics
NPI:1407468366
Name:PLATINUM CHOICE HEALTHCARE
Entity Type:Organization
Organization Name:PLATINUM CHOICE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FLOOR MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-418-0718
Mailing Address - Street 1:1489 W PALMETTO PARK RD STE 512
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-3326
Mailing Address - Country:US
Mailing Address - Phone:561-418-0718
Mailing Address - Fax:
Practice Address - Street 1:1489 W PALMETTO PARK RD STE 512
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-3326
Practice Address - Country:US
Practice Address - Phone:561-418-0718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty