P.B. & R's Enterprises LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

ME86204 Issued in FL

Legal business name

P.B. & R'S ENTERPRISES LLC

Doing business as

Prana Blu Medspa

Practice address

1200 S Highland Ave
Suite 'B'
Clearwater, FL 33756-4334

Phone

(727) 330-7733

Fax

(727) 447-6008

NPI assigned

Dec 16, 2011

Last updated

Dec 16, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Bethzali Del C. Phillips, M.E.

Title

Managing Memeber

Phone

(727) 330-7733

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Prana Blu Medspa Doing business as

Locations

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323993600000",
    "number": "1396014536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S HIGHLAND AVE",
            "address_2": "SUITE 'B'",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564334",
            "telephone_number": "727-330-7733",
            "fax_number": "727-447-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S HIGHLAND AVE",
            "address_2": "SUITE 'B'",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337564334",
            "telephone_number": "727-330-7733",
            "fax_number": "727-447-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.B. & R'S ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2011-12-16",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "BETHZALI",
        "authorized_official_middle_name": "DEL C.",
        "authorized_official_title_or_position": "MANAGING MEMEBER",
        "authorized_official_telephone_number": "727-330-7733",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.E."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME86204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1851697056",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278958500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER PTAN",
            "identifier": "P00945853",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prana Blu Medspa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Kate Owens
• Pearl Owusu-Bugyei
• Oliver N. Oyama, PH.D, PA-C
• Addison Aydin Ozakyol
• Delia Villanueva Ozoa, REGISTERED NURSE
• P&K Medical Supplies & Equipment, Inc.
• P3 Health Partners-Florida LLC
• Sheila Pabon, M.D
• Hadleigh Pagano
• Christina Page, ATC, OT-C

• Primary Care Clinic/Center in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2011; 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.