Provider Demographics
NPI:1134307879
Name:TRITAIK, RACHEL SALVAGE (PT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:SALVAGE
Last Name:TRITAIK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:CLAIRE
Other - Last Name:SALVAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 867
Mailing Address - Street 2:
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957-0867
Mailing Address - Country:US
Mailing Address - Phone:239-297-4997
Mailing Address - Fax:239-395-5857
Practice Address - Street 1:695 TARPON BAY RD UNIT 1
Practice Address - Street 2:
Practice Address - City:SANIBEL
Practice Address - State:FL
Practice Address - Zip Code:33957-3135
Practice Address - Country:US
Practice Address - Phone:239-395-5858
Practice Address - Fax:239-395-5857
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 13489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAL996Medicare PIN