Organization
PRO-TECH SPORTS MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA LEEDS (ADMINISTRATOR)
(305) 668-2860
Entity
Organization
Contact information
Practice address
7241 SW 63RD AVE, SUITE 102A, SOUTH MIAMI, FL 33143-4838
(305) 668-2860
(305) 668-2862
Mailing address
7241 SW 63RD AVE, SUITE 102A, SOUTH MIAMI, FL 33143-4838
(305) 668-2860
(305) 668-2862
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
P02792
FL
213ES0000X
Sports Medicine Podiatrist
P02027
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45915
BCBS GROUP #
FL
Enumeration date
06/04/2007
Last updated
03/19/2009
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