Provider Demographics
NPI:1285146068
Name:FIRST CHOICE PRIMARY CARE
Entity type:Organization
Organization Name:FIRST CHOICE PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:863-658-2563
Mailing Address - Street 1:3750 EMERGENCY LANE STE 1
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870
Mailing Address - Country:US
Mailing Address - Phone:863-658-2563
Mailing Address - Fax:863-304-8598
Practice Address - Street 1:3750 EMERGENCY LANE STE 1
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870
Practice Address - Country:US
Practice Address - Phone:863-658-2563
Practice Address - Fax:863-304-8598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-01
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty