Provider Demographics
NPI:1356439509
Name:PEACHEY, AUXI (MD)
Entity Type:Individual
Prefix:
First Name:AUXI
Middle Name:
Last Name:PEACHEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11870 DOWNY BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5515
Mailing Address - Country:US
Mailing Address - Phone:305-934-1834
Mailing Address - Fax:
Practice Address - Street 1:11924 BALM RIVERVIEW RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33569-6601
Practice Address - Country:US
Practice Address - Phone:813-672-3200
Practice Address - Fax:813-672-3202
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 96623207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME 96623OtherMEDICAL LICENSE