Provider Demographics
NPI:1154092872
Name:HARVEY, RAELYNN CHRISTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:RAELYNN
Middle Name:CHRISTINE
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 W LAS OLAS BLVD APT 2000
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-3098
Mailing Address - Country:US
Mailing Address - Phone:239-357-1093
Mailing Address - Fax:
Practice Address - Street 1:1608 TOWN CENTER BLVD STE A
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3639
Practice Address - Country:US
Practice Address - Phone:954-349-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant