Provider Demographics
NPI:1598036063
Name:A WISE CHOICE FL MEDICAL BILLING COMPANY, LLC.
Entity Type:Organization
Organization Name:A WISE CHOICE FL MEDICAL BILLING COMPANY, LLC.
Other - Org Name:A WISE CHOICE FL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:BILLER,CODER,COLLECT
Authorized Official - Phone:561-526-3950
Mailing Address - Street 1:PO BOX 16414
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33416-6414
Mailing Address - Country:US
Mailing Address - Phone:561-526-3950
Mailing Address - Fax:561-828-3163
Practice Address - Street 1:1326 MONTERAY WAY
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33413-3010
Practice Address - Country:US
Practice Address - Phone:561-526-3950
Practice Address - Fax:561-828-3163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-15
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty