Provider Demographics
NPI:1275642407
Name:FIRST CHOICE MEDICAL CENTER
Entity type:Organization
Organization Name:FIRST CHOICE MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALPHA
Authorized Official - Last Name:LIBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-539-2111
Mailing Address - Street 1:697 MAITLAND AVE
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-6821
Mailing Address - Country:US
Mailing Address - Phone:407-539-2111
Mailing Address - Fax:407-539-1211
Practice Address - Street 1:697 MAITLAND AVE
Practice Address - Street 2:SUITE 1001
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-6821
Practice Address - Country:US
Practice Address - Phone:407-539-2111
Practice Address - Fax:407-539-1211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty