Healthcare Provider Details

I. General information

NPI: 1629993936
Provider Name (Legal Business Name): RAYNIE'S HRT & MED SPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 CARDINAL POINT DR STE 103
JACKSONVILLE FL
32257-9238
US

IV. Provider business mailing address

3560 CARDINAL POINT DR STE 103
JACKSONVILLE FL
32257-9238
US

V. Phone/Fax

Practice location:
  • Phone: 904-543-3474
  • Fax: 904-605-4525
Mailing address:
  • Phone: 904-543-3474
  • Fax: 904-605-4525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAYNIE PRESLEY
Title or Position: OWNER/MA
Credential:
Phone: 904-543-3474