NPIMap

Organization Active NPI

Injury Treatment Center of Coral Springs Inc

Doing business as Choice Medical Center

  • General Practice Physician
  • Wilton Manors, FL
National Provider Identifier
1396866653
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
HCC3662 Issued in FL
Legal business name
INJURY TREATMENT CENTER OF CORAL SPRINGS INC
Doing business as
Choice Medical Center
Practice address
871 W Oakland Park Blvd
Wilton Manors, FL 33311-1731
Phone
(954) 567-5730
Fax
(954) 567-5733
NPI assigned
Apr 3, 2007
Last updated
Apr 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Evan Sade
Title
Credentialing Dept
Phone
(954) 817-9402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X HCC3662 FL Primary

Addresses

Primary practice location

871 W Oakland Park Blvd
Wilton Manors, FL 33311-1731

Mailing address

2295 NW Corporate Blvd
Suite 140
Boca Raton, FL 33431-7373
Phone (561) 241-1971

Other identifiers 1

IdentifierTypeStateIssuer
34548OtherFLBLUE SHIELD NUMBER

Other names 1

  • Choice Medical Center Doing business as

National Provider Directory

National Provider Directory

Locations

871 W Oakland Park Blvd
Wilton Manors, FL 33311
Phone (954) 567-7141

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1396866653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 NW CORPORATE BLVD",
            "address_2": "SUITE 140",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334317373",
            "telephone_number": "561-241-1971",
            "fax_number": "561-241-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 W OAKLAND PARK BLVD",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333111731",
            "telephone_number": "954-567-5730",
            "fax_number": "954-567-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INJURY TREATMENT CENTER OF CORAL SPRINGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "SADE",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "CREDENTIALING DEPT",
        "authorized_official_telephone_number": "954-817-9402"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "HCC3662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD NUMBER",
            "identifier": "34548",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Choice Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilton Manors, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.