Provider Demographics
NPI:1417598582
Name:MILLINES, RACQUEL GEORGETTE
Entity Type:Individual
Prefix:
First Name:RACQUEL
Middle Name:GEORGETTE
Last Name:MILLINES
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 1:205 NE 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-3126
Mailing Address - Country:US
Mailing Address - Phone:561-667-6479
Mailing Address - Fax:
Practice Address - Street 1:205 NE 13TH AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-3126
Practice Address - Country:US
Practice Address - Phone:561-667-6479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide