Healthcare Provider Details

I. General information

NPI: 1619456746
Provider Name (Legal Business Name): PROACTIVE MEDICAL SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17808 KEY VISTA WAY
BOCA RATON FL
33496-1040
US

IV. Provider business mailing address

17808 KEY VISTA WAY
BOCA RATON FL
33496-1040
US

V. Phone/Fax

Practice location:
  • Phone: 646-456-4407
  • Fax: 888-254-2756
Mailing address:
  • Phone: 646-456-4407
  • Fax: 888-254-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberOS14167
License Number StateFL

VIII. Authorized Official

Name: DR. CHARLENE MONICA SCHEIM
Title or Position: OWNER
Credential: DO
Phone: 646-456-4407