Healthcare Provider Details

I. General information

NPI: 1508967183
Provider Name (Legal Business Name): PAUL FRANK RAUEN MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 RAYMOND ST ORLANDO VA HEALTHCARE CENTER
ORLANDO FL
32803-8208
US

IV. Provider business mailing address

4170 S KIRKMAN RD APT 719
ORLANDO FL
32811-2853
US

V. Phone/Fax

Practice location:
  • Phone: 407-629-1599
  • Fax:
Mailing address:
  • Phone: 407-297-0633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: