Provider Demographics
NPI:1245494798
Name:PIRAKMI, INC
Entity type:Organization
Organization Name:PIRAKMI, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:UNIDAD
Authorized Official - Middle Name:R
Authorized Official - Last Name:BONOAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:813-961-6887
Mailing Address - Street 1:104 E GARLAND CT
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1826
Mailing Address - Country:US
Mailing Address - Phone:813-961-6887
Mailing Address - Fax:813-961-4147
Practice Address - Street 1:104 E GARLAND CT
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1826
Practice Address - Country:US
Practice Address - Phone:813-961-6887
Practice Address - Fax:813-961-4147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL 7336310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL140556000Medicaid