Provider Demographics
NPI:1780194464
Name:DOCTOR'S CHOICE MEDICAL CENTER
Entity Type:Organization
Organization Name:DOCTOR'S CHOICE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISBEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FIGUEREDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-433-8900
Mailing Address - Street 1:4670 FOREST HILL BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-5640
Mailing Address - Country:US
Mailing Address - Phone:561-433-8900
Mailing Address - Fax:561-433-4117
Practice Address - Street 1:9164 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952
Practice Address - Country:US
Practice Address - Phone:772-446-4066
Practice Address - Fax:772-333-2949
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOCTOR'S CHOICE MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-06
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC11066261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHCC8303OtherCLINIC