MEDICARE: DR. REMO RAINA M.D.

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	173000000X	Legal Medicine	ME101124	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972756765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REMO RAINA M.D.

Provider Business Mailing Address
First Line	:	1930 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5509
Country	:	US
Telephone Number	:	772-335-3184
Fax Number	:	772-335-4256

Provider Business Practice Location Address
First Line	:	1701 SE HILLMOOR DR
Second Line	:	SUITE 4
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-7552
Country	:	US
Telephone Number	:	772-240-9485
Fax Number	:

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

Provider Enumeration Date	:	10/24/2008
Last Update Date	:	10/07/2019

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