Provider Demographics
NPI:1417355884
Name:PADAWER, RACHEL (SA-C, CSFA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:PADAWER
Suffix:
Gender:F
Credentials:SA-C, CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:1551 CLAY ST
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-5499
Practice Address - Country:US
Practice Address - Phone:407-644-5371
Practice Address - Fax:407-644-1417
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-16
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14-572246ZC0007X
363AS0400X
FL161310246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical