Provider Demographics
NPI:1346232931
Name:CALENDINE, RAELYN MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:RAELYN
Middle Name:MICHELLE
Last Name:CALENDINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:252 MACARTHUR DR
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954
Mailing Address - Country:US
Mailing Address - Phone:412-944-4714
Mailing Address - Fax:941-235-2712
Practice Address - Street 1:4161 TAMIAMI TRAIL
Practice Address - Street 2:UNIT 401
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952
Practice Address - Country:US
Practice Address - Phone:941-235-2710
Practice Address - Fax:941-235-2712
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35080520207Q00000X
OH35 080520207Q00000X
OH35.080520207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000560905OtherANTHEM BC/BS
OH749737OtherBUCKEYE
05405OtherPARAMOUNT HEALTH CARE
0425160001OtherMEDICARE DMEPOS
FL14L8KOtherBCBS
OH2770747Medicaid
FLGG337ZMedicare PIN
05405OtherPARAMOUNT HEALTH CARE
0425160001OtherMEDICARE DMEPOS
FL14L8KOtherBCBS