Healthcare Provider Details

I. General information

NPI: 1194642231
Provider Name (Legal Business Name): PUREHEALTHY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7777 131ST ST STE 1/2
SEMINOLE FL
33776-4017
US

IV. Provider business mailing address

7777 131ST ST STE 1/2
SEMINOLE FL
33776-4017
US

V. Phone/Fax

Practice location:
  • Phone: 727-361-9415
  • Fax:
Mailing address:
  • Phone: 727-361-9415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: BRITTNEY ROY
Title or Position: MANAGER
Credential:
Phone: 727-361-9415