Provider Demographics
NPI:1750123923
Name:PRO-CURA LLC
Entity type:Organization
Organization Name:PRO-CURA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MNGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:YCAZA
Authorized Official - Suffix:
Authorized Official - Credentials:OS7473
Authorized Official - Phone:813-451-8646
Mailing Address - Street 1:17900 GULF BLVD APT 17C
Mailing Address - Street 2:
Mailing Address - City:REDINGTON SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33708-1101
Mailing Address - Country:US
Mailing Address - Phone:813-451-8646
Mailing Address - Fax:
Practice Address - Street 1:17900 GULF BLVD APT 17C
Practice Address - Street 2:
Practice Address - City:REDINGTON SHORES
Practice Address - State:FL
Practice Address - Zip Code:33708-1101
Practice Address - Country:US
Practice Address - Phone:813-451-8646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty