Pro Health Mso, LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

PRO HEALTH MSO, LLC

Practice address

3100 17TH St
Saint Cloud, FL 34769-6021

Phone

(407) 891-3500

NPI assigned

Sep 11, 2012

Last updated

Sep 11, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joseph J. Dicapua

Title

Ceo

Phone

(561) 843-7720

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347321600000",
    "number": "1427308055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 COCONUT CREEK PKWY",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330633916",
            "telephone_number": "561-843-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 17TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696021",
            "telephone_number": "407-891-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO HEALTH MSO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-11",
        "last_updated": "2012-09-11",
        "status": "A",
        "authorized_official_last_name": "DICAPUA",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-843-7720"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Saint Cloud, FL
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• Health Maintenance Organization in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.