Provider Demographics
NPI:1417274135
Name:ACCARDO, REBEKKA ANNALISA
Entity Type:Individual
Prefix:
First Name:REBEKKA
Middle Name:ANNALISA
Last Name:ACCARDO
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 1:5149 N 9TH AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8734
Mailing Address - Country:US
Mailing Address - Phone:850-477-9253
Mailing Address - Fax:850-494-9843
Practice Address - Street 1:5149 N 9TH AVE STE 120
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8734
Practice Address - Country:US
Practice Address - Phone:850-477-9253
Practice Address - Fax:850-494-9843
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3203972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily