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Individual

DR. MICHAEL E RAIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
501 HARBOR BLVD, SUITE D, DESTIN, FL 32541-2348
(850) 837-9161
(850) 837-9162
Mailing address
501 HARBOR BLVD, SUITE D, DESTIN, FL 32541-2348
(850) 837-9161
(850) 837-9162

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPC0001111
FL
152WX0102X
Occupational Vision Optometrist
OPC0001111
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1245500677
ORGANIZATION NPI
FL
Enumeration date
06/28/2006
Last updated
01/05/2017
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