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:
Map and Directions
Authorized official contact:
Name: Iacovone, Domenic
Phone: (772) 631-1563

Health care specialties

SpecialtyCodeLicense #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 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376072181 NPPES
Florida Other OS10791 GROUP PRACTICE SPECIALITY

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