Provider Demographics
NPI:1306812375
Name:RACHEL, MARCHELLE JE-ANN (PT, DPT)
Entity type:Individual
Prefix:
First Name:MARCHELLE
Middle Name:JE-ANN
Last Name:RACHEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 HAWKS VIEW DR
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-8011
Mailing Address - Country:US
Mailing Address - Phone:754-234-5319
Mailing Address - Fax:
Practice Address - Street 1:2038 HAWKS VIEW DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-8011
Practice Address - Country:US
Practice Address - Phone:754-234-5319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT187582251P0200X, 222Q00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002254000Medicaid
FL016699900Medicaid
FLY911WOtherBLUE CROSS BLUE SHIELD