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NPI Code Detail

MEDICARE: ALECIA RAGER MSW

MEDICARE: ALECIA RAGER MSW
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
11041C0700XClinical Social WorkerISW9851FL

General Provider Information

NPI Number : 1962900464
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALECIA RAGER MSW
Provider Business Mailing Address
First Line : 12000 LUCCA ST APT 201
Second Line :
City : FORT MYERS
State : FL
Zip : 33966-5366
Country : US
Telephone Number : 239-410-6221
Fax Number :
Provider Business Practice Location Address
First Line : 390 PONDELLA RD STE 9
Second Line :
City : NORTH FORT MYERS
State : FL
Zip : 33903-4340
Country : US
Telephone Number : 239-652-0260
Fax Number : 239-652-0146
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2018
Last Update Date : 01/30/2018

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1053970194 — ULTIMA REHAB-FL LLC
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