Provider Demographics
NPI:1992716690
Name:RAIJER, CAROLINA (ARNP)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:RAIJER
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 W GORE ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-1141
Mailing Address - Country:US
Mailing Address - Phone:321-841-3338
Mailing Address - Fax:321-841-2170
Practice Address - Street 1:60 W GORE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1141
Practice Address - Country:US
Practice Address - Phone:321-841-3338
Practice Address - Fax:321-841-2170
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9130750207RI0011X
FLARNP9180750363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9130750OtherMEDICAL LICENSE
FL307435800Medicaid
FLAK515YMedicare PIN
FL307435800Medicaid
FLAK515XMedicare PIN