Organization
PRO LIFE MEDICAL CENTER CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANUEL JOSE AMIGO GUILLEN (OWNER)
(305) 965-1525
Entity
Organization
Contact information
Practice address
7925 NW 12TH ST STE 315, DORAL, FL 33126-1846
(305) 965-1525
Mailing address
7925 NW 12TH ST STE 315, DORAL, FL 33126-1846
(305) 965-1525
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/12/2021
Last updated
03/08/2024
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