Provider Demographics
NPI:1922712116
Name:MINDFULLY PAIN FREE, LLC
Entity Type:Organization
Organization Name:MINDFULLY PAIN FREE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARISELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CIGLIUTI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:727-213-8994
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34681-0460
Mailing Address - Country:US
Mailing Address - Phone:727-213-8994
Mailing Address - Fax:
Practice Address - Street 1:303 MAIN ST STE N
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5733
Practice Address - Country:US
Practice Address - Phone:727-213-8994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNAOtherNA