PURA VIDA MEDICAL CENTER, LLC (NPI# 1124646898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124646898 |
| Entity Type | Organization |
| Organization Name | PURA VIDA MEDICAL CENTER, LLC |
| Practice Address |
15529 Bull Run Rd Miami Lakes FL 33014-7004 |
| Mailing Address |
7925 Nw 12th St Ste 201 Doral FL 33126-1821 |
| Practice Telephone | 3053288922 |
| Practice Fax Number | 7862246489 |
| Mailing Telephone | 3058743909 |
| Mailing Fax Number | 3058743916 |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |
| Authorized Official Name | MISS NURY CARBAJAL (CEO) |
| Authorized Official Telephone | 3058743909 |
| Is Organization Subpart | Y |
| Parent Organization Name | PURA VIDA MEDICAL CENTER, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Pura Vida Medical Center | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922523604 | Pura Vida Medical Center, LLC | Clinic/Center | 1738 W 49th St Ste 7-12, Hialeah, FL 33012-3456 | 2017-08-03 |
| 1861040552 | Pura Vida Medical Center, LLC | General Practice | 1738 W 49th St Ste 10, Hialeah, FL 33012-3457 | 2019-08-27 |
| Street Address |
15529 BULL RUN RD |
| City | MIAMI LAKES |
| State | FL |
| Zip Code | 33014-7004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720254113 | Cristina Agostinelli | Specialist | 15529 Bull Run Rd, Miami Lakes, FL 33014-7004 | 2008-05-05 |
| 1669918678 | Carmen M Guanipa | Nurse Practitioner | 15529 Bull Run Rd, Miami Lakes, FL 33014 | 2017-01-13 |
| 1437522752 | Wilmer R. Santiesteban Garcia | Nurse Practitioner | 15529 Bull Run Rd, Miami Lakes, FL 33014 | 2015-11-09 |
| 1659625689 | Julian Cedeno | Nurse Practitioner | 15529 Bull Run Rd, Miami Lakes, FL 33014-7004 | 2012-10-29 |
| 1417236019 | Interamerican Medical Center Group LLC | Family Medicine | 15529 Bull Run Rd, Miami Lakes, FL 33014-7004 | 2011-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568083830 | Mj Pharmacy & Discount LLC | Pharmacy | 1545 West 62nd Street, Suite 62, Hialeah, FL 33014 | 2020-04-28 |
| 1699301333 | Alexander Tamayo Ochoa | Nurse Practitioner | 5400 Nw 159 St Apt 123, Hialeah, FL 33014 | 2020-03-13 |
| 1609336114 | Edward Alexander Pardo | Counselor | 6225 Miami Lakes Drive, Hialeah, FL 33014 | 2019-03-21 |
| 1780158394 | Remedys Nutrition Cv | Pharmacy | 7331 Miami Lakes Dr, Miami Lakes, FL 33014 | 2019-01-16 |
| 1962993642 | Yuleika Rodriguez Gonzalez | Behavior Technician | 6961 W 14th Ct Apt 203, Hialeah, FL 33014 | 2018-05-29 |
| 1730676719 | Bright Steps Therapy Services LLC | Physical Therapy Assistant | 1900 W 68th St Apt E306, Hialeah, FL 33014 | 2018-04-16 |
| 1093211443 | One Soul Cmh Inc | Case Management | 5803 Nw 151st St Ste 202, Miami Lakes, FL 33014 | 2018-04-04 |
| 1528560331 | Yuramis Perez Salvador | Behavior Technician | 8365 W 18 Lane Dr, Hialeah, FL 33014 | 2018-03-07 |
| 1396253613 | Miami Lakes Behavioral Services Corp | Behavioral Analyst | 6001 Nw 153rd Street, Suite 157, Miami Lakes, FL 33014 | 2018-01-22 |
| 1447768452 | Ballast Medical Management, LLC. | Exclusive Provider Organization | 6001 Nw 153rd St Ste 100, Miami Lakes, FL 33014 | 2018-01-12 |
| Find all providers in zip 33014 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164044293 | Jwh Miami Lakes I, LLC | General Practice | 16320 Nw 59 Ave, Miami Lakes, FL 33014-6879 | 2020-05-12 |
| 1528593696 | Esmeralda Medical Center Corp | General Practice | 14100 Palmetto Frntg Rd, Suite 105, Miami Lakes, FL 33016-1569 | 2017-04-26 |
| 1326497918 | Hilario A. Isaba Md Pa | General Practice | 7234 Bedlington Rd, Miami Lakes, FL 33014-8000 | 2016-06-06 |
| 1225435530 | Fidel Lorenzo Rodriguez | General Practice | 16836 Nw 91st Ave, Miami Lakes, FL 33018 | 2014-12-02 |
| 1932510484 | Mendez J Medical Office Pa | General Practice | 16420 Nw 59th Ave, Miami Lakes, FL 33014-5602 | 2014-05-17 |
| 1659707099 | Usa Medical Services Unlimeted Corp | General Practice | 6001 Nw 153rd St Ste 102, Miami Lakes, FL 33014-2447 | 2013-09-17 |
| 1649557059 | Jorge Enrique Fernandez | General Practice | 16325 Nw 78 Th Ave, Miami Lakes, FL 33016 | 2011-11-14 |
| 1184893034 | Professional Medical Health Services LLC | General Practice | 5190 Nw 167th St Ste 104, Miami Lakes, FL 33014-6337 | 2008-02-25 |
| 1740464825 | Care Solutions Medical Group LLC | General Practice | 15529 Bull Run Road, Miami Lakes, FL 33014 | 2007-12-24 |
| 1477185494 | Maria Del Carmen Curbelo Calleiro | General Practice | 5190 Nw 167th St Ste 109, Miami Lakes, FL 33014-6329 | 2020-02-07 |
| Find all providers in MIAMI LAKES | ||||
| City | MIAMI LAKES |
| Zip Code | 33014 |
Please comment or provide details below to improve the information on PURA VIDA MEDICAL CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.