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General NPI Number Information
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NPI Number | 1902612641
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Entity Type | Organization
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Legal Business Name | PURE LIFE NURSE REGISTRY CORP
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Dates
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Enumeration Date | 12/07/2024
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 8210 W WATERS AVE
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City | TAMPA
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State | FL
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Zip | 33615-1814
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Country | US
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Telephone | 813-542-3613
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Fax |
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Provider Business Mailing Address
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Address Line | 8210 W WATERS AVE
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City | TAMPA
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State | FL
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Zip | 33615-1814
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Country | US
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Telephone | 813-302-9400
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LORENA LAGO ALONSO
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Credential |
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Telephone | 813-302-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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