Pura Vida Chiropractic Center PA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH6133 Issued in FL

Legal business name

PURA VIDA CHIROPRACTIC CENTER PA

Practice address

11435 W Palmetto Park Rd Ste G
Boca Raton, FL 33428-2602

Phone

(561) 487-3788

Fax

(561) 487-3166

NPI assigned

Jul 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Israel Maldonado Jr., CHIROPRACTOR

Title

Director

Phone

(561) 487-3788

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1164612388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11435 W PALMETTO PARK RD STE G",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334282602",
            "telephone_number": "561-487-3788",
            "fax_number": "561-487-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11435 W PALMETTO PARK RD STE G",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334282602",
            "telephone_number": "561-487-3788",
            "fax_number": "561-487-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURA VIDA CHIROPRACTIC CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-487-3788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CHIROPRACTOR"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH6133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380492500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; 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.