Provider Demographics
NPI:1891947198
Name:RAGLAND, MICHELE (MS,ATC,LAT,RT(R),PES)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:RAGLAND
Suffix:
Gender:F
Credentials:MS,ATC,LAT,RT(R),PES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 ADELAIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-3656
Mailing Address - Country:US
Mailing Address - Phone:321-217-8913
Mailing Address - Fax:
Practice Address - Street 1:211 ADELAIDE BLVD
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3656
Practice Address - Country:US
Practice Address - Phone:321-217-8913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL18422255A2300X
OH314882247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist