Provider Demographics
NPI:1457091696
Name:CHOICES FIRST POINT OF CARE LLC
Entity Type:Organization
Organization Name:CHOICES FIRST POINT OF CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAQUANDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-475-2263
Mailing Address - Street 1:2330 SAINT LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34946-6724
Mailing Address - Country:US
Mailing Address - Phone:772-475-2263
Mailing Address - Fax:
Practice Address - Street 1:2330 SAINT LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34946-6724
Practice Address - Country:US
Practice Address - Phone:772-475-2263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service