Healthcare Provider Details

I. General information

NPI: 1356257133
Provider Name (Legal Business Name): RAYNAL EASY MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3016 SW 10TH PL
CAPE CORAL FL
33914-4218
US

IV. Provider business mailing address

3016 SW 10TH PL
CAPE CORAL FL
33914-4218
US

V. Phone/Fax

Practice location:
  • Phone: 618-882-1204
  • Fax:
Mailing address:
  • Phone: 618-882-1204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DOMINICK JOHNSON
Title or Position: OWNER
Credential:
Phone: 618-882-1204