Provider Demographics
NPI:1366949935
Name:DHANI, RACHEL SHELLEY (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:SHELLEY
Last Name:DHANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:KATHERINE
Other - Last Name:SHELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2165 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4410
Mailing Address - Country:US
Mailing Address - Phone:727-372-6637
Mailing Address - Fax:
Practice Address - Street 1:2165 LITTLE RD
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4410
Practice Address - Country:US
Practice Address - Phone:727-372-6637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL142539207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine