MEDICARE: PURA VIDA DAY CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA0600X	Adult Day Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9672	OTHER	FL	AHCA

General Provider Information

NPI Number	:	1659210532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURA VIDA DAY CENTER LLC

Provider Business Mailing Address
First Line	:	6626 HANLEY RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-4704
Country	:	US
Telephone Number	:	813-605-3374
Fax Number	:	813-605-3375

Provider Business Practice Location Address
First Line	:	6626 HANLEY RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33634-4704
Country	:	US
Telephone Number	:	813-605-3374
Fax Number	:	813-605-3375

Authorized Official
Title or Position	:	OWNER
Name	:	YVONNE WONG
Credential	:
Telephone Number	:	813-403-9513

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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Directions to “PURA VIDA DAY CENTER LLC ” Practice Location

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