Provider Demographics
NPI:1679683304
Name:RAINEY, ADRIANA CELIS
Entity Type:Individual
Prefix:
First Name:ADRIANA CELIS
Middle Name:
Last Name:RAINEY
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 1:156 E BAYRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3533
Mailing Address - Country:US
Mailing Address - Phone:954-394-0292
Mailing Address - Fax:
Practice Address - Street 1:2229 N COMMERCE PKWY STE 200A
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3239
Practice Address - Country:US
Practice Address - Phone:954-659-8986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT1412OtherLICENSE#