Healthcare Provider Details

I. General information

NPI: 1407324866
Provider Name (Legal Business Name): MAJOR RAINIER CAUSING
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 04/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2925 E SOUTH ST
ORLANDO FL
32803-6459
US

IV. Provider business mailing address

2925 E SOUTH ST
ORLANDO FL
32803-6459
US

V. Phone/Fax

Practice location:
  • Phone: 407-780-0759
  • Fax: 888-344-9692
Mailing address:
  • Phone: 818-428-8075
  • Fax: 888-344-9692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: