Provider Demographics
NPI:1447830922
Name:PHOENIX PRO MANAGEMENT, INC
Entity type:Organization
Organization Name:PHOENIX PRO MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MODRIC
Authorized Official - Suffix:
Authorized Official - Credentials:CONTRACTOR
Authorized Official - Phone:561-591-7597
Mailing Address - Street 1:700 S ROSEMARY AVE STE 204-2052
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6313
Mailing Address - Country:US
Mailing Address - Phone:561-236-9384
Mailing Address - Fax:361-210-1136
Practice Address - Street 1:700 S ROSEMARY AVE STE 204-2052
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-6313
Practice Address - Country:US
Practice Address - Phone:561-236-9384
Practice Address - Fax:361-210-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-09
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
No171WV0202XOther Service ProvidersContractorVehicle ModificationsGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty