Provider Demographics
NPI:1588677439
Name:RAGIN-DAMES, LORRIEN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:LORRIEN
Middle Name:
Last Name:RAGIN-DAMES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:LORRIEN
Other - Middle Name:
Other - Last Name:RAGIN-DAMES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:1601 NW 12TH AVE
Mailing Address - Street 2:ROOM 5031
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-243-6092
Mailing Address - Fax:305-243-3919
Practice Address - Street 1:1601 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-6092
Practice Address - Fax:305-243-3919
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1433842363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301489400Medicaid
FL03349OtherSTAYWELL
FLY6129OtherBCBS
FL152410OtherWELLCARE
S36732Medicare UPIN
FLY6129Medicare ID - Type Unspecified