MEDICARE: MRS. RACHAEL ANN RILEY-KINLAW

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
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1730126947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RACHAEL ANN RILEY-KINLAW

Provider Business Mailing Address
First Line	:	8540 SW 133RD AVENUE RD
Second Line	:	306
City	:	MIAMI
State	:	FL
Zip	:	33183-4515
Country	:	US
Telephone Number	:	786-663-0441
Fax Number	:	305-386-4675

Provider Business Practice Location Address
First Line	:	8540 SW 133RD AVENUE RD
Second Line	:	306
City	:	MIAMI
State	:	FL
Zip	:	33183-4515
Country	:	US
Telephone Number	:	786-663-0441
Fax Number	:	305-386-4675

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/08/2007

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