Organization
PROACTIVE MEDICAL DIAGNOSTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIZAR SOUAYAH MD (MEDICAL DIRECTOR)
(800) 268-1346
Entity
Organization
Contact information
Practice address
3001 N ROCKY POINT DR, STE 200, TAMPA, FL 33607-5802
(800) 268-1346
(800) 809-6184
Mailing address
3001 N ROCKY POINT DR, STE 200, TAMPA, FL 33607-5802
(800) 268-1346
(800) 809-6184
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
ME 102562
FL
Other
Enumeration date
02/23/2007
Last updated
07/29/2009
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