Organization
PROACTIVE HEALTH CENTER, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OTTO MARQUES (VICE PRESIDENT)
(239) 200-1970
Entity
Organization
Contact information
Practice address
3400 LEE BLVD UNIT 111, LEHIGH ACRES, FL 33971-1309
(239) 200-1970
Mailing address
3400 LEE BLVD UNIT 111, LEHIGH ACRES, FL 33971-1309
(239) 200-1970
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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