Provider Demographics
NPI:1063448249
Name:PROFESSIONAL TECHNICAL GROUP INC
Entity Type:Organization
Organization Name:PROFESSIONAL TECHNICAL GROUP INC
Other - Org Name:PTG PHARMACY AND DISCOUNT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARSENIO
Authorized Official - Middle Name:L
Authorized Official - Last Name:CASALS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-253-9528
Mailing Address - Street 1:15916 SW 137TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-1204
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15916 SW 137TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-1204
Practice Address - Country:US
Practice Address - Phone:305-253-9528
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5270440001Medicare NSC