Organization
PURA VIDA PAIN CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIARA WILLIAMS (OWNER)
(813) 980-6700
Entity
Organization
Contact information
Practice address
4801 E BUSCH BLVD, UNIT A, TAMPA, FL 33617-6416
(813) 980-6700
(813) 980-6711
Mailing address
4801 E BUSCH BLVD, UNIT A, TAMPA, FL 33617-6416
(813) 980-6700
(813) 980-6711
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MM18936
MASSAGE EST LICENSE
FL
Enumeration date
05/17/2007
Last updated
08/22/2020
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