Organization
PRO ACTIVE THERAPEUTICS
Active
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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