Provider Demographics
NPI:1518212711
Name:1ST MEDICAL CHOICE INC
Entity Type:Organization
Organization Name:1ST MEDICAL CHOICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMT/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HANDRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-458-9942
Mailing Address - Street 1:11285 SW 211 STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33189
Mailing Address - Country:US
Mailing Address - Phone:305-458-9942
Mailing Address - Fax:
Practice Address - Street 1:11285 SW 211 STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33189
Practice Address - Country:US
Practice Address - Phone:305-458-9942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC10186261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service