Provider Demographics
NPI:1033395652
Name:DELVALLE, RACHEL (PT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DELVALLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 NE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:BISCAYNE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33161-6225
Mailing Address - Country:US
Mailing Address - Phone:305-323-3645
Mailing Address - Fax:305-883-6301
Practice Address - Street 1:7911 NW 72ND AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:MEDLEY
Practice Address - State:FL
Practice Address - Zip Code:33166-2227
Practice Address - Country:US
Practice Address - Phone:305-883-6180
Practice Address - Fax:305-883-6301
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT13299225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8717AMedicare PIN