Healthcare Provider Details
I. General information
NPI: 1992595276
Provider Name (Legal Business Name): KAYLEE RABAJA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
545 BRENT LN
PENSACOLA FL
32503-2003
US
IV. Provider business mailing address
545 BRENT LN
PENSACOLA FL
32503-2003
US
V. Phone/Fax
- Phone: 850-463-6970
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174N00000X |
| Taxonomy | Lactation Consultant (Non-RN) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WL0100X |
| Taxonomy | Lactation Consultant (Registered Nurse) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KAYLEE
RABAJA
Title or Position: CEO
Credential: RN, IBCLC
Phone: 864-293-3958