Provider Demographics
NPI:1578753752
Name:STENGEL, RAYNA AVRA (AP, DOM, LMT)
Entity Type:Individual
Prefix:MS
First Name:RAYNA
Middle Name:AVRA
Last Name:STENGEL
Suffix:
Gender:F
Credentials:AP, DOM, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 MIDDLE RIVER DR
Mailing Address - Street 2:APT A
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1406
Mailing Address - Country:US
Mailing Address - Phone:239-258-0272
Mailing Address - Fax:
Practice Address - Street 1:2544 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-1621
Practice Address - Country:US
Practice Address - Phone:239-258-0272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2703171100000X
FLMA 67818172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No172M00000XOther Service ProvidersMechanotherapist