Provider Demographics
NPI:1194735688
Name:CARECCIA, RACHEL E (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:CARECCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:38135 MARKET SQ
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33542-7505
Mailing Address - Country:US
Mailing Address - Phone:813-528-4975
Mailing Address - Fax:
Practice Address - Street 1:3820 NORTHDALE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-1863
Practice Address - Country:US
Practice Address - Phone:813-712-5702
Practice Address - Fax:813-377-1005
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME96058207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU8903X - PASCOMedicare PIN
FLU8903W- TPAMedicare PIN