| Organization Name: | PRISON REHABILITATIVE INDUSTRIES & DIVERSIFIED ENTERPRISES |
| NPI Number: | 1275834129 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENISE KIMINKI (ASSISTANT SECRETARY TO THE BOARD) |
| Mailing Address: | 12425 28th St. N. Suite 300 St. Petersburg |
| State: | FL US |
| Postal Code: | 33716 |
| Phone Number: | 7275563300 |
| Fax Number: | 7275703449 |
| NPI Enumeration Date: | 11/09/2010 |
| NPI Last Update Date: | 11/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 292200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Laboratories |
| Taxonomy Classification: | Dental Laboratory |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A commercial laboratory specializing in the construction of dental appliances that conform to a dentist |