Healthcare Provider Details

I. General information

NPI: 1063929628
Provider Name (Legal Business Name): THE RAYNE GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2018
Last Update Date: 05/03/2025
Certification Date: 05/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 PARKWAY ST
DAYTONA BEACH FL
32114-3031
US

IV. Provider business mailing address

428 AUBURN DR APT 102
DAYTONA BEACH FL
32118-3248
US

V. Phone/Fax

Practice location:
  • Phone: 386-233-3060
  • Fax:
Mailing address:
  • Phone: 386-216-6184
  • Fax: 386-206-1145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: GUERLYNE BELLEVUE
Title or Position: PRESIDENT
Credential:
Phone: 386-233-3060