NPI Code Detail JSON Logo

1053002691 NPI number — ALEXANDRA ELISSE RAINE MS, OTR/L

NPI Number: 1053002691
Health Care Provider/Practitioner: ALEXANDRA ELISSE RAINE MS, OTR/L

Information about “1053002691” NPI (ALEXANDRA ELISSE RAINE MS, OTR/L) exists in 1053002691 in HTML format HTML  |  1053002691 in plain Text format TXT  |  1053002691 in PDF (Portable Document Format) PDF  |  1053002691 in an XML format XML  formats.

NPI Number : 1053002691 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053002691",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RAINE",
    "FirstName": "ALEXANDRA",
    "MiddleName": "ELISSE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MS, OTR/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PALACIO",
    "OtherFirstName": "ALEXANDRA",
    "OtherMiddleName": "ELISSE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "MS, OTR/L",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "8087 SW 86TH TER",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIAMI",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33143-7028",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "15321 SW 74TH PL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PALMETTO BAY",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33157-2488",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "305-965-0828",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/16/2023",
    "LastUpdateDate": "01/13/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225XP0200X",
          "TaxonomyName": "Pediatric Occupational Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "222Q00000X",
          "TaxonomyName": "Developmental Therapist",
          "LicenseNumber": "OT24012",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225X00000X",
          "TaxonomyName": "Occupational Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.