Healthcare Provider Details

I. General information

NPI: 1295654598
Provider Name (Legal Business Name): RAYNA M COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3544 SAINT JOHNS BLUFF RD S APT 903
JACKSONVILLE FL
32224-2674
US

IV. Provider business mailing address

3544 SAINT JOHNS BLUFF RD S APT 903
JACKSONVILLE FL
32224-2674
US

V. Phone/Fax

Practice location:
  • Phone: 904-852-7167
  • Fax:
Mailing address:
  • Phone: 904-852-7167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: