Prohealth Medical Group INC.
Clinic/Center, Health Services in Miami, FL. Organization (NPI-2).
NPI number1164086815
StatusActive
Last updated in NPPESOct 22, 2024
Details
- NPI
- 1164086815
- Entity type
- Organization (NPI-2)
- Legal business name
- Prohealth Medical Group INC.
- Organization subpart
- No
- Enumeration date
- Apr 29, 2019
- Certification date
- Oct 22, 2024
- Last updated
- Oct 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QH0100X | Clinic/Center, Health Services | – | – | Yes |
Practice location
175 Fontainebleau Blvd Ste 2k2Miami, FL 33172-7014
Phone 407-914-7189 · Fax 786-334-6140
Mailing address
175 Fontainebleau Blvd Ste 2k2Miami, FL 33172-7014
Phone 786-334-6094 · Fax 786-334-6140
Authorized official
Juan R Afonso Manso
President
4079147189
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