# MY CHOICE OPERATING COMPANY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mobile Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174112007
- **Authorized official:** MR. ROBERT G YOUNG (SECRETARY & CAO)
- **Authorized official phone:** (904) 733-1003

## Contact information

- **Practice address:** 4655 SALISBURY RD STE 220, JACKSONVILLE, FL 32256-0959
- **Practice address phone:** (904) 570-9404
- **Practice address fax:** (904) 900-2224
- **Mailing address:** 4655 SALISBURY RD STE 110, JACKSONVILLE, FL 32256-0957
- **Mailing address phone:** (904) 733-1003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/14/2021
- **Last updated:** 12/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 10D2178878 | CLIA | FL |
| 05 | — | 110526700 | — | FL |
| 01 | — | 12550 | AHCA | FL |