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Organization
PROACTIVEMED LLC
Active
Organization
PROACTIVEMED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEDRO D SANTIAGO LUGO MD (OWNER / PRESIDENT)
(787) 243-6966
Entity
Organization
Contact information
Practice address
URBANIZACION PEREYO, CALLE ORION 9, HUMACAO, PR 00791
(787) 998-2040
(787) 266-8423
Mailing address
PO BOX 1327, GURABO, PR 00778-1327
(787) 998-2040
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
133NN1002X
Nutrition Education Nutritionist
—
NULL
133NN1002X
Nutrition Education Nutritionist
—
—
133V00000X
Registered Dietitian
—
NULL
133V00000X
Registered Dietitian
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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