Provider Demographics
NPI:1275894818
Name:AZZARELLI, RACHEL M (PA-C)
Entity Type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:M
Last Name:AZZARELLI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2863 S DELANEY AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-5412
Mailing Address - Country:US
Mailing Address - Phone:407-843-1620
Mailing Address - Fax:407-843-5243
Practice Address - Street 1:2863 S DELANEY AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-5412
Practice Address - Country:US
Practice Address - Phone:407-843-1620
Practice Address - Fax:407-843-5243
Is Sole Proprietor?:No
Enumeration Date:2012-05-30
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9106551363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant