Healthcare Provider Details

I. General information

NPI: 1659210532
Provider Name (Legal Business Name): PURA VIDA DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6626 HANLEY RD
TAMPA FL
33634-4704
US

IV. Provider business mailing address

6626 HANLEY RD
TAMPA FL
33634-4704
US

V. Phone/Fax

Practice location:
  • Phone: 813-605-3374
  • Fax: 813-605-3375
Mailing address:
  • Phone: 813-605-3374
  • Fax: 813-605-3375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: YVONNE WONG
Title or Position: OWNER
Credential:
Phone: 813-403-9513