Individual provider · Type 1 NPI

Colette R. Raine, PA-C

Medical Physician Assistant · St. Petersburg, FL

NPI number 1679197495 Active

Practice location

7901 4th St N Ste 300
St. Petersburg, FL 33702-4399

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA9113340 (FL)
Student in an Organized Health Care Education/Training Program 390200000XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1679197495

Colette R. Raine, PA-C's National Provider Identifier is 1679197495, issued on Jun 8, 2020. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in St. Petersburg, FL. The record was last updated on Oct 10, 2023.