PROLIVE MEDICAL RESEARCH CORP NPI 1336656495

NPI Information

  • NPI: 1336656495
  • Provider Name: PROLIVE MEDICAL RESEARCH CORP
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Former Legal Business Name: PROLIVE MEDICAL RESEARCH CORP
  • CLIA Number: 10D2067272
  • Address: 12781 SW 42ND ST STE I
    MIAMI, FL
    ZIP 33175
  • Phone: (305) 221-8001

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NPI Details

PROLIVE MEDICAL RESEARCH CORP is a clinic center in Miami, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PROLIVE MEDICAL RESEARCH CORP NPI is 1336656495. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Prolive Medical Research Corp.

The provider's business location address is:

12781 SW 42ND ST STE I
MIAMI, FL
ZIP 33175-437
Phone: (305) 221-8001

The provider's authorized official is Laura Diaz .
The authorized official title is Site Director and has the following contact phone number (305) 221-8001.

The CLIA number assigned to this NPI record is 10D2067272 - other - clinical research with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/10/2018 and was last updated on 1/10/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========OTHERFLORIDACLINICAL RESEARCH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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