Pro Performance Anti Aging And Pharmaceutical Supplementation Llc
LBN: Pro Performance Anti Aging And Pharmaceutical Supplementation Llc
Pro Performance Anti Aging And Pharmaceutical Supplementation Llc is an health care organization with primary practice located at 4865 Sw Golfside Dr , Palm City FL 34990-7917. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Ambulatory Health Care Facilities / Multi-Specialty. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Pro Performance Anti Aging And Pharmaceutical Supplementation Llc can be contacted via phone (772) 631-1563, or through Iacovone, Domenic via phone (772) 631-1563.
Contact Information
Primary practice address
4865 Sw Golfside Dr
Palm City FL 34990-7917
Phone: (772) 631-1563
Fax: (772) 463-2344
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | OS10791 | Florida |
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | OS10791 | Florida |
Profile Details
| NPI number | 1376072181 |
|---|---|
| LBN Legal business name | Pro Performance Anti Aging And Pharmaceutical Supplementation Llc |
| DBA Doing business as | |
| Authorized official | Iacovone, Domenic |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 6th, 2017 |
| Last updated | Jul 21st, 2022 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376072181 | NPPES |
| Florida | Other | OS10791 | GROUP PRACTICE SPECIALITY |
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