Provider Demographics
NPI:1699404400
Name:TILLINGER, RAQUEL LINEVSKY
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:LINEVSKY
Last Name:TILLINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 WEYBURN TER APT C18
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2895
Mailing Address - Country:US
Mailing Address - Phone:954-465-5529
Mailing Address - Fax:
Practice Address - Street 1:4300 ALTON RD STE 1190
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2948
Practice Address - Country:US
Practice Address - Phone:954-465-5529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
1234OtherN/A