Provider Demographics
NPI:1396768487
Name:CHOI, MICHAEL P (DO)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:P
Last Name:CHOI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7150 W 20TH AVE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5529
Mailing Address - Country:US
Mailing Address - Phone:305-558-4428
Mailing Address - Fax:305-364-1295
Practice Address - Street 1:7150 W 20TH AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5529
Practice Address - Country:US
Practice Address - Phone:305-558-4428
Practice Address - Fax:305-364-1295
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8975174400000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL90862OtherBCBS OF FLORIDA
FL306068OtherAVMED
FL057259OtherNHP
FL276343500Medicaid
I09022Medicare UPIN
FL90862OtherBCBS OF FLORIDA