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Organization
MY CHOICE OPERATING COMPANY LLC
Active
Organization
MY CHOICE OPERATING COMPANY LLC
Active
Other names
Mobile Medical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT G YOUNG (SECRETARY & CAO)
(904) 733-1003
Entity
Organization
Contact information
Practice address
4655 SALISBURY RD STE 220, JACKSONVILLE, FL 32256-0959
(904) 570-9404
(904) 900-2224
Mailing address
4655 SALISBURY RD STE 110, JACKSONVILLE, FL 32256-0957
(904) 733-1003
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
208D00000X
General Practice Physician
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2178878
CLIA
FL
05
—
110526700
—
FL
01
—
12550
AHCA
FL
Enumeration date
01/14/2021
Last updated
12/27/2023
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