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Organization

PRO ACTIVE THERAPEUTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PEDRO MIGUEL LOPEZ PTA (MANAGER)
(305) 389-3978
Entity
Organization

Contact information

Practice address
4280 SW 73RD AVE, MIAMI, FL 33155-4548
(305) 389-3978
Mailing address
11884 SW 253RD ST, HOMESTEAD, FL 33032-5863
(305) 389-3978

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
11/17/2020
Last updated
11/17/2020
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