Provider Demographics
NPI:1285199786
Name:RAPHAEL, CHRISTIANA
Entity Type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:
Last Name:RAPHAEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18574 SW 55TH ST
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33029-6294
Mailing Address - Country:US
Mailing Address - Phone:954-704-3940
Mailing Address - Fax:954-431-0917
Practice Address - Street 1:18574 SW 55TH ST
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029-6294
Practice Address - Country:US
Practice Address - Phone:954-704-3940
Practice Address - Fax:954-431-0917
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide