Active NPI
Puremind Wellness Center LLC
- Developmentally Disabled Services Day Training Agency
- Clearwater, FL
National Provider Identifier
1649070574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- Legal business name
- PUREMIND WELLNESS CENTER LLC
- Practice address
- 5500 Rio Vista Dr
Clearwater, FL 33760-3140 - Phone
- (786) 825-9383
- NPI assigned
- Mar 18, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wendy Hernandez
- Title
- Owner
- Phone
- (786) 825-9383
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | Primary | ||
| Community/Behavioral Health Agency | 251S00000X |
Addresses
Primary practice location
5500 Rio Vista Dr
Clearwater, FL 33760-3140
Mailing address
8339 42ND Ave N
Saint Petersburg, FL 33709-3946
Phone (786) 825-9383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250612000569 | FL | Part B Supplier - Clinic/Group Practice | 9537679030 |
Receives reassigned benefits from 1 practitioner Practice locations: Clearwater, FL |
National Provider Directory
National Provider DirectoryLocations
5500 Rio Vista Dr
Clearwater, FL 33760
Phone (727) 524-2896
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742256000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1764806400000",
"number": "1649070574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8339 42ND AVE N",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337093946",
"telephone_number": "786-825-9383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 RIO VISTA DR",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337603140",
"telephone_number": "786-825-9383"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PUREMIND WELLNESS CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-03-18",
"last_updated": "2025-12-04",
"certification_date": "2025-12-04",
"status": "A",
"authorized_official_last_name": "HERNANDEZ",
"authorized_official_first_name": "WENDY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "786-825-9383"
},
"taxonomies": [
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.