Provider Demographics
NPI:1003534934
Name:DEXTER, RACHEL DARLENE
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:DARLENE
Last Name:DEXTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 N GARRISON ST APT A
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-2354
Mailing Address - Country:US
Mailing Address - Phone:813-263-5864
Mailing Address - Fax:
Practice Address - Street 1:3404 N GARRISON ST APT A
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-2354
Practice Address - Country:US
Practice Address - Phone:813-263-5864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-17
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No347C00000XTransportation ServicesPrivate Vehicle