Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pro Performance Anti Aging and Pharmaceutical Supplementation LLC

Organization Sports Medicine (Orthopaedic Surgery) Physician · NPI 1376072181

Pro Performance Anti Aging and Pharmaceutical Supplementation LLC is a Sports Medicine (Orthopaedic Surgery) Physician in Palm City, Florida. Licensed in Florida. Registered with an NPI since 2017.

Licensed in
FL
In the registry since
2017
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4865 SW Golfside Dr
Palm City, FL 34990-7917
Phone: (772) 631-1563
Fax: (772) 463-2344
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Multi-Specialty Clinic/Center (primary) Taxonomy 261QM1300X · Licence OS10791 (FL)
Sports Medicine (Orthopaedic Surgery) Physician Taxonomy 207XX0005X · Licence OS10791 (FL)

Record details

NPI number1376072181
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Domenic Iacovone — President · (772) 631-1563
NPI enumeratedJune 6, 2017
Last updated in NPPESJuly 21, 2022
Mailing address4865 Sw Golfside Dr, Palm City, FL 34990-7917