Provider Demographics
NPI:1558583112
Name:FIRST CHOICE PERSONAL INJURY CLINIC, INC.
Entity Type:Organization
Organization Name:FIRST CHOICE PERSONAL INJURY CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DEPARTMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-931-1750
Mailing Address - Street 1:2916 W WATERS AVE
Mailing Address - Street 2:STE A-2
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614
Mailing Address - Country:US
Mailing Address - Phone:813-931-1750
Mailing Address - Fax:813-931-1757
Practice Address - Street 1:2916 W WATERS AVE
Practice Address - Street 2:STE A-2
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614
Practice Address - Country:US
Practice Address - Phone:813-931-1750
Practice Address - Fax:813-931-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6040261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty