Pure Rehabilitation South, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PURE REHABILITATION SOUTH, LLC

Practice address

18650 Gulf Blvd Unit 414
Indian Shores, FL 33785-2080

Phone

(712) 542-0123

Fax

(712) 850-1349

NPI assigned

Feb 4, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Misty Ann Haffner-Szynskie

Title

Admin

Phone

(712) 542-0123

Specialties & licenses 1

Addresses

Other names 1

• Pure Rehabilitation Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1124772553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18650 GULF BLVD UNIT 414",
            "city": "INDIAN SHORES",
            "state": "FL",
            "postal_code": "337852080",
            "telephone_number": "712-542-0123",
            "fax_number": "712-850-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18650 GULF BLVD UNIT 414",
            "city": "INDIAN SHORES",
            "state": "FL",
            "postal_code": "337852080",
            "telephone_number": "712-542-0123",
            "fax_number": "712-850-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE REHABILITATION SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-04",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "HAFFNER-SZYNSKIE",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMIN",
        "authorized_official_telephone_number": "712-542-0123"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pure Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Indian Shores, FL
• Providers in Indian Shores, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.