1528228897 NPI number — RAYLA M BABIN R, MR

Table of content: RAYLA M BABIN R, MR (NPI 1528228897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528228897 NPI number — RAYLA M BABIN R, MR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BABIN
Provider First Name:
RAYLA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R, MR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528228897
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1691
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TALLAHASSEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32302-1691
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-668-3537
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2910 KERRY FOREST PKWY
Provider Second Line Business Practice Location Address:
STE A1-A
Provider Business Practice Location Address City Name:
TALLAHASSEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32309-6892
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-894-9500
Provider Business Practice Location Address Fax Number:
850-894-9501
Provider Enumeration Date:
06/11/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2471C3402X , with the licence number:  CRT 47466 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2471M1202X , with the licence number: 318451 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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