Individual
JOSE LUIS PROENZA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 JUPITER LAKES BLVD, BUILDING 3000 SUITE 106, JUPITER, FL 33458-7191
(561) 746-6300
(561) 746-6376
Mailing address
210 JUPITER LAKES BLVD, BUILDING 3000 SUITE 106, JUPITER, FL 33458-7191
(561) 746-6300
(561) 746-6376
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME62386
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26491
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/18/2005
Last updated
07/08/2007
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