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Organization

PROACTIVEMED LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PEDRO D SANTIAGO LUGO MD (OWNER / PRESIDENT)
(787) 243-6966
Entity
Organization

Contact information

Practice address
URBANIZACION PEREYO, CALLE ORION 9, HUMACAO, PR 00791
(787) 998-2040
(787) 266-8423
Mailing address
PO BOX 1327, GURABO, PR 00778-1327
(787) 998-2040

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
133NN1002X
Nutrition Education Nutritionist
133V00000X
Registered Dietitian
207R00000X
Internal Medicine Physician
Primary
363AM0700X
Medical Physician Assistant

Other

Enumeration date
10/03/2023
Last updated
10/03/2023
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