Provider Demographics
NPI:1427316470
Name:RAYE, JUSTIN MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:MICHAEL
Last Name:RAYE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5111 8TH AVENUE DR W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3707
Mailing Address - Country:US
Mailing Address - Phone:941-920-2190
Mailing Address - Fax:
Practice Address - Street 1:2750 BAHIA VISTA ST STE 100
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2640
Practice Address - Country:US
Practice Address - Phone:941-951-2663
Practice Address - Fax:941-552-3312
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS14621208VP0014X
AZ0069182081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine