# PROACTIVEMED LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841070208
- **Authorized official:** PEDRO D SANTIAGO LUGO MD (OWNER / PRESIDENT)
- **Authorized official phone:** (787) 243-6966

## Contact information

- **Practice address:** URBANIZACION PEREYO, CALLE ORION 9, HUMACAO, PR 00791
- **Practice address phone:** (787) 998-2040
- **Practice address fax:** (787) 266-8423
- **Mailing address:** PO BOX 1327, GURABO, PR 00778-1327
- **Mailing address phone:** (787) 998-2040

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 10/03/2023
- **Last updated:** 10/03/2023