NPIMap

Organization Active NPI

Prison Rehabilitative Industries & Diversified Enterprises

  • Dental Laboratory
  • St. Petersburg, FL
National Provider Identifier
1275834129
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental LaboratoryTaxonomy code 292200000X
Legal business name
PRISON REHABILITATIVE INDUSTRIES & DIVERSIFIED ENTERPRISES
Practice address
12425 28TH St. N.
Suite 300
St. Petersburg, FL 33716
Phone
(727) 556-3300
Fax
(727) 570-3449
NPI assigned
Nov 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Authorized official

Name
Miss Denise Kiminki
Title
Assistant Secretary to the Board
Phone
(727) 556-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Laboratory 292200000X FL Primary

Addresses

Primary practice location

12425 28TH St. N.
Suite 300
St. Petersburg, FL 33716

Mailing address

12425 28TH St N
Suite 300
St Petersburg, FL 33716-1844
Phone (727) 556-3300

Other names 1

  • PRIDE Enterprises Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pride Broward Optical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1275834129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12425 28TH ST N",
            "address_2": "SUITE 300",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337161844",
            "telephone_number": "727-556-3300",
            "fax_number": "727-570-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12425 28TH ST. N.",
            "address_2": "SUITE 300",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33716",
            "telephone_number": "727-556-3300",
            "fax_number": "727-570-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISON REHABILITATIVE INDUSTRIES & DIVERSIFIED ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "KIMINKI",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY TO THE BOARD",
        "authorized_official_telephone_number": "727-556-3300",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRIDE Enterprises",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St. Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.