Provider Demographics
NPI:1841212958
Name:LADIES FIRST CHOICE INC
Entity Type:Organization
Organization Name:LADIES FIRST CHOICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAVLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-535-4446
Mailing Address - Street 1:1930 TEMPLE TERRACE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-6649
Mailing Address - Country:US
Mailing Address - Phone:727-791-8801
Mailing Address - Fax:727-530-4003
Practice Address - Street 1:2337 BELLEAIR RD
Practice Address - Street 2:SUITE E
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-1729
Practice Address - Country:US
Practice Address - Phone:727-535-4446
Practice Address - Fax:727-796-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL09134OtherWELLCARE HMO
FLM0757OtherBCBS FL
FLM0757OtherBCBS FL