Healthcare Provider Details

I. General information

NPI: 1023034089
Provider Name (Legal Business Name): CAROLINE S. RAINS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 SE 24TH ST ACHD
GAINESVILLE FL
32641-7516
US

IV. Provider business mailing address

224 SE 24TH ST
GAINESVILLE FL
32641-7516
US

V. Phone/Fax

Practice location:
  • Phone: 352-334-7900
  • Fax:
Mailing address:
  • Phone: 352-334-7906
  • Fax: 352-334-8897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME41334
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: