Individual
COLETTE R RAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7901 4TH ST N STE 300, SAINT PETERSBURG, FL 33702-4399
(407) 550-7755
Mailing address
7901 4TH ST N STE 300, ST PETERSBURG, FL 33702-4399
(407) 550-7755
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9113340
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/08/2020
Last updated
10/10/2023
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