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1639882426 NPI number — DR. EBONI SHAVONE RAINEY-HAYNES

NPI Number: 1639882426
Health Care Provider/Practitioner: DR. EBONI SHAVONE RAINEY-HAYNES

Information about “1639882426” NPI (DR. EBONI SHAVONE RAINEY-HAYNES) exists in 1639882426 in HTML format HTML  |  1639882426 in plain Text format TXT  |  1639882426 in PDF (Portable Document Format) PDF  |  1639882426 in an XML format XML  formats.

NPI Number : 1639882426 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639882426",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RAINEY-HAYNES",
    "FirstName": "EBONI",
    "MiddleName": "SHAVONE",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "RAINEY",
    "OtherFirstName": "EBONI",
    "OtherMiddleName": "S",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "DR",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "851 W STATE ROAD 436 STE 1005",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALTAMONTE SPRINGS",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32714-3055",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "407-383-0643",
    "MailingAddressFaxNumber": "407-266-0977",
    "FirstLinePracticeLocationAddress": "851 W STATE ROAD 436 STE 1005",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALTAMONTE SPRINGS",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32714-3055",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "407-383-0643",
    "PracticeLocationAddressFaxNumber": "407-266-0977",
    "EnumerationDate": "12/27/2022",
    "LastUpdateDate": "12/27/2022",
    "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": "174400000X",
        "TaxonomyName": "Specialist",
        "LicenseNumber": "FB9767225",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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