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Organization
PRO HEALTH HERITAGE SQUARE LLC
Active
Organization
PRO HEALTH HERITAGE SQUARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH J. DICAPUA (MGRM)
(561) 843-7720
Entity
Organization
Contact information
Practice address
901 E OAK ST, SUITE A, KISSIMMEE, FL 34744-5837
(561) 843-7720
Mailing address
2301 NW 33RD CT, SUITE 11, POMPANO BEACH, FL 33069-1000
(954) 586-8058
(954) 283-1083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0069080
FL
207RP1001X
Pulmonary Disease Physician
ME19806
FL
Other
Enumeration date
01/02/2013
Last updated
04/04/2013
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