RAIMAH PRIMARY CARE CENTER PA (NPI# 1174719629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174719629 |
| Entity Type | Organization |
| Organization Name | RAIMAH PRIMARY CARE CENTER PA |
| Practice Address |
1283 Sw State Road 47 103 Lake City FL 32025-0489 |
| Mailing Address |
1283 Sw State Road 47 Suite103 Lake City FL 32025-0489 |
| Practice Telephone | 3867540339 |
| Practice Fax Number | 3867540393 |
| Mailing Telephone | 3867540339 |
| Mailing Fax Number | 3867540393 |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2012-12-11 |
| Authorized Official Name | DR. MARIE RAIME (DOCTOR) |
| Authorized Official Telephone | 3867540339 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
ME85010 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 264300600 | 05 |
| Street Address |
1283 SW STATE ROAD 47 103 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32025-0489 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801866405 | Mohammad A Faisal | Internal Medicine | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2006-01-25 |
| 1174063127 | Nicole Polbos | Nurse Practitioner | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2017-02-24 |
| 1023453222 | Begum Internal Medicine LLC | Legal Medicine | 1283 Sw State Road 47, Suite 101, Lake City, FL 32025-0489 | 2013-05-02 |
| 1366680357 | Tohmina Begum | Internal Medicine | 1283 Sw State Road 47, Suite 101, Lake City, FL 32025-0489 | 2009-01-28 |
| 1407884018 | Marie Raime | Family Medicine | 1283 Sw State Road 47, Suite 103, Lake City, FL 32025-0489 | 2006-06-30 |
| 1689639353 | Mohammad Ali Faisal, M.d., P.a. | Specialist | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0490 | 2006-04-18 |
| 1629048228 | Ricardo J Rosado | Internal Medicine | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
| 1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
| 1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
| 1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
| 1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
| 1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
| 1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
| 1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
| 1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
| 1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
| Find all providers in zip 32025 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275842916 | Samuel Pryn Barker IIi | Family Medicine | 2806 W Us Highway 90, Suite 102, Lake City, FL 32055-4745 | 2010-09-29 |
| 1699138917 | Denise Driscoll | Family Medicine | 340 Nw Commerce Dr, Lake City, FL 32055-4709 | 2016-04-04 |
| 1053486456 | Dawn Wilson | Family Medicine | 5499 Jonesboro Rd, Lake City, GA 30260-3553 | 2006-11-21 |
| 1588755029 | Ut Van Tran | Family Medicine | 619 S Marion Ave, Lake City, FL 32025 | 2006-09-28 |
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|---|---|---|---|---|
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| 1831704345 | Vasundhara Kuchibhotla | Family Medicine | 1630 Sw 75th Ter, Gainesville, FL 32607-6604 | 2020-09-11 |
| 1356952170 | Discreet Health Solutions, LLC | Family Medicine | 7124 Pelican Island Dr, Tampa, FL 33634-7463 | 2020-08-14 |
| 1033728019 | Nana Aisha Garba | Family Medicine | 11200 Sw 8th St Ahc2 Rm 589b, Miami, FL 33199-0001 | 2020-07-27 |
| 1043838451 | Lisa M Parker | Family Medicine | 7955 Bay St Ste 2, Sebastian, FL 32958-3282 | 2020-07-13 |
| 1699390336 | Rosenie B Jasmin | Family Medicine | Dove Medical Centers, LLC, 2901 West Oakland Park Blvd Ste A4-5, Oakland Park, FL 33311 | 2020-06-09 |
| 1588287239 | Sarai L Gonzalez | Family Medicine | 16182 Nw 21st St, Pembroke Pines, FL 33028-1255 | 2020-05-28 |
| 1184247033 | Wellness Solutions 2020 LLC | Family Medicine | 2300 N Commerce Pkwy Ste 321, Weston, FL 33326-3257 | 2020-05-27 |
| 1780207910 | Homeville Medical Care | Family Medicine | 11040 Nw 18th Ct, Plantation, FL 33322-3407 | 2020-05-21 |
| 1942829536 | Health Medical Ultra Limited Liability Company | Family Medicine | 1760 Havendale Blvd Nw, Winter Haven, FL 33881-1224 | 2020-04-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.