Provider Demographics
NPI:1811196785
Name:MEDCHOICE OF AIRPORT, L.L.C.
Entity Type:Organization
Organization Name:MEDCHOICE OF AIRPORT, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PALACIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-398-0807
Mailing Address - Street 1:PO BOX 141799
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33114-1799
Mailing Address - Country:US
Mailing Address - Phone:305-643-3311
Mailing Address - Fax:305-643-8604
Practice Address - Street 1:3628 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4069
Practice Address - Country:US
Practice Address - Phone:305-643-3311
Practice Address - Fax:305-643-8604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Multi-Specialty