Provider Demographics
NPI:1255433124
Name:ALEXANDER, RAINA CARRIEL (MD)
Entity type:Individual
Prefix:
First Name:RAINA
Middle Name:CARRIEL
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 W HIGHWAY 98
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-5923
Mailing Address - Country:US
Mailing Address - Phone:850-453-6737
Mailing Address - Fax:850-453-1196
Practice Address - Street 1:6715 W HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-5923
Practice Address - Country:US
Practice Address - Phone:850-453-6737
Practice Address - Fax:850-453-1196
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-00374207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905654Medicaid
NC5905654Medicaid
NCI71016Medicare UPIN