Provider Demographics
NPI:1285686345
Name:RAPKE, STEPHANIE L (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:RAPKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1031
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32802-1031
Mailing Address - Country:US
Mailing Address - Phone:407-872-7786
Mailing Address - Fax:407-872-3630
Practice Address - Street 1:4416 SUN N LAKE BLVD
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33872
Practice Address - Country:US
Practice Address - Phone:863-382-2049
Practice Address - Fax:863-382-2830
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ579152085R0001X
FLME916442085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11415TOtherMEDICARE
FL11415SOtherMEDICARE
FL11415UOtherMEDICARE
FL271049800Medicaid
FL11415UOtherMEDICARE
FLP00252644Medicare PIN
FL271049800Medicaid
FL11415WMedicare PIN
FL11415SOtherMEDICARE
FL11415YMedicare PIN
FL11415ZMedicare ID - Type UnspecifiedMEDICARE