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General NPI Number Information
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NPI Number | 1023026150
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Entity Type | Organization
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Legal Business Name | PURA VIDA MEDICAL SUPPLIES INC
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15715 S DIXIE HWY SUITE418
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City | MIAMI
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State | FL
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Zip | 33157-1800
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Country | US
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Telephone | 305-238-3464
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Fax | 305-238-3494
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Provider Business Mailing Address
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Address Line | 210 NW 107TH AVE APT 203
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City | MIAMI
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State | FL
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Zip | 33172-7817
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Country | US
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Telephone | 305-238-3464
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Fax | 305-238-3494
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ORLANDO CLAUSELL
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Credential |
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Telephone | 305-238-3464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | FL
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