Pro Active Therapeutics

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PRO ACTIVE THERAPEUTICS

Practice address

4280 SW 73Rd Ave
Miami, FL 33155-4548

Phone

(305) 389-3978

NPI assigned

Nov 17, 2020

Organization subpart

No

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

Authorized official

Name

Pedro Miguel Lopez, PTANPI 1952641276

Title

Manager

Phone

(305) 389-3978

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pedro Miguel Lopez, PTA

  • Physical Therapy Assistant
  • Miami, FL
  • NPI 1952641276
  NPD Authorized official

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605571200000",
    "number": "1699378349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11884 SW 253RD ST",
            "city": "HOMESTEAD",
            "state": "FL",
            "postal_code": "330325863",
            "telephone_number": "305-389-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 SW 73RD AVE",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331554548",
            "telephone_number": "305-389-3978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO ACTIVE THERAPEUTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "MIGUEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "305-389-3978",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divya Selena Pritipaul
• Private Healthcare Facilities
• Private Medical Center Inc
• Privee Miami LLC
• Tatachar Priyamvada, M.D.
• Pro Health Medical Centers LLC
• Pro Healthcare Services Inc
• Pro Life Health Medical Center LLC
• Pro Medical Institute Inc
• Pro Medics Therapy & Rehab Center, LLC

• Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.