Provider Demographics
NPI:1386999100
Name:RAINEY, IAN ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:IAN
Middle Name:ROBERT
Last Name:RAINEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 PINEHURST RD
Mailing Address - Street 2:STE E
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-5408
Mailing Address - Country:US
Mailing Address - Phone:727-314-2663
Mailing Address - Fax:888-394-4159
Practice Address - Street 1:1130 PINEHURST RD
Practice Address - Street 2:STE E
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5408
Practice Address - Country:US
Practice Address - Phone:727-314-2663
Practice Address - Fax:888-394-4159
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4276111N00000X
FLCH11734111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLGCYIFOtherFL BLUE
FLIK232ZMedicare PIN