Basic Information
| Provider Information | |||||||||
| NPI: | 1124156401 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAAB | ||||||||
| FirstName: | ENID | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 840207 | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330842207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055954510 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9370 SUNSET DRIVE | ||||||||
| Address2: | # A- 250 | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3055958816 | ||||||||
| FaxNumber: | 3055959465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN 736852 | FL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.