Provider Demographics
NPI:1477788990
Name:CHOI, HANFF, MIRABELLO, SHIM AND TORKE MDS LLP
Entity Type:Organization
Organization Name:CHOI, HANFF, MIRABELLO, SHIM AND TORKE MDS LLP
Other - Org Name:FLORIDA SPORTS ORTHOPAEDIC AND SPINE MEDICINE WESTCHASE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-787-5577
Mailing Address - Street 1:3890 TAMPA RD
Mailing Address - Street 2:STE #202
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-3676
Mailing Address - Country:US
Mailing Address - Phone:727-787-5577
Mailing Address - Fax:727-781-7398
Practice Address - Street 1:12780 RACE TRACK RD
Practice Address - Street 2:SUITE 200 BAYCARE OUTPATIENT CENTER
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626
Practice Address - Country:US
Practice Address - Phone:727-787-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty