Organization
DR. MICHAEL E. RAIM OD P.A. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E. RAIM O.D. (PRESIDENT)
(850) 837-9161
Entity
Organization
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
OC0001111
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205864402
NPI
—
Enumeration date
01/02/2012
Last updated
04/19/2012
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