| Proactive Health Corp | |
|
3750 W 16th Ave Ste 218 Hialeah FL 33012-4648 | |
| (786) 409-3231 | |
| Not Available |
| Full Name | Proactive Health Corp |
|---|---|
| Speciality | Behavior Analyst |
| Location | 3750 W 16th Ave Ste 218, Hialeah, Florida |
| Authorized Official Name and Position | Liuva Cruz Duque (PRESIDENT) |
| Authorized Official Contact | 7863897598 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Proactive Health Corp 3750 W 16th Ave Ste 218 Hialeah FL 33012-4648 Ph: (786) 409-3231 | Proactive Health Corp 3750 W 16th Ave Ste 218 Hialeah FL 33012-4648 Ph: (786) 409-3231 |
| NPI Number | 1497117683 |
|---|---|
| Provider Enumeration Date | 03/25/2016 |
| Last Update Date | 03/12/2024 |
| Certification Date | 03/12/2024 |
| Medicare PECOS PAC ID | 4981027265 |
|---|---|
| Medicare Enrollment ID | O20200702002156 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497117683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 235Z00000X | Speech-language Pathologist | SA14278 (* (Not Available)) | Secondary |
| Provider Name | Ricardo O Grinbank |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750422572 PECOS PAC ID: 5698931962 Enrollment ID: I20120801000136 |
| Provider Name | Liuva Cruz Duque |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427468776 PECOS PAC ID: 7517380892 Enrollment ID: I20200702002214 |
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