Organization · NPI-2

1st Choice Providers LLC

Clinic/Center · Tampa, FL

NPI number1891414512
StatusActive
Last updated in NPPESAug 25, 2022

Details

NPI
1891414512
Entity type
Organization (NPI-2)
Legal business name
1st Choice Providers LLC
Organization subpart
No
Enumeration date
Aug 25, 2022
Certification date
Aug 25, 2022
Last updated
Aug 25, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

812 W Dr Martin Luther King Jr Blvd Ste 202
Tampa, FL 33603-3338

Phone 813-468-3796

Mailing address

812 W Dr Martin Luther King Jr Blvd Ste 202
Tampa, FL 33603-3338

Phone 813-468-3796

Authorized official

Daniel Westbrook
Owner
8134683796

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