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NPI Code Detail

MEDICARE: RAYMON DEAN PRIEWE DO

MEDICARE: RAYMON DEAN PRIEWE DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) PhysicianOS5370FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16408040001OTHERFLPTAN
21629020508OTHERFLNPI GROUP #

General Provider Information

NPI Number : 1578565362
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMON DEAN PRIEWE DO
Provider Business Mailing Address
First Line : 6815 14TH ST W
Second Line : SUITE204
City : BRADENTON
State : FL
Zip : 34207-5810
Country : US
Telephone Number : 941-758-7300
Fax Number : 941-758-7334
Provider Business Practice Location Address
First Line : 6815 14TH ST W
Second Line : SUITE204
City : BRADENTON
State : FL
Zip : 34207-5810
Country : US
Telephone Number : 941-758-7300
Fax Number : 941-758-7334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 09/15/2011

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