| Raimah Primary Care Center Pa | |
|
1283 Sw State Road 47 103 Lake City FL 32025-0489 | |
| (386) 754-0339 | |
| (386) 754-0393 |
| Full Name | Raimah Primary Care Center Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1283 Sw State Road 47, Lake City, Florida |
| Authorized Official Name and Position | Marie Raime (DOCTOR) |
| Authorized Official Contact | 3867540339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Raimah Primary Care Center Pa 1283 Sw State Road 47 Suite103 Lake City FL 32025-0489 Ph: (386) 754-0339 | Raimah Primary Care Center Pa 1283 Sw State Road 47 103 Lake City FL 32025-0489 Ph: (386) 754-0339 |
| NPI Number | 1174719629 |
|---|---|
| Provider Enumeration Date | 09/19/2007 |
| Last Update Date | 12/11/2012 |
| Medicare PECOS PAC ID | 8527088590 |
|---|---|
| Medicare Enrollment ID | O20051206000307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174719629 | NPI | - | NPPES |
| 264300600 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | ME85010 (Florida) | Primary |
| Provider Name | Marie Raime |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407884018 PECOS PAC ID: 7416915350 Enrollment ID: I20041227000029 |
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