Pro Performance Anti Aging and Pharmaceutical Supplementation LLC

NPI #1376072181 in Palm City, Florida

Provider Information

NPI Number: 1376072181
Entity Type: Organization
Organization Name: Pro Performance Anti Aging and Pharmaceutical Supplementation LLC
Primary Specialty: Clinic/Center - Multi-Specialty
Enumeration Date: Jun 6, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 4865 SW GOLFSIDE DR
City: Palm City
State: Florida
ZIP Code: 34990-7917
Phone: (772) 631-1563

Authorized Official

Name: MR. DOMENIC IACOVONE
Title: PRESIDENT
Phone: (772) 631-1563

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery - Sports Medicine — Sports Medicine	207XX0005X
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X	Primary

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