Provider Demographics
NPI:1497477921
Name:RHEINGOLD, NETTECHA M (CMF)
Entity Type:Individual
Prefix:
First Name:NETTECHA
Middle Name:M
Last Name:RHEINGOLD
Suffix:
Gender:F
Credentials:CMF
Other - Prefix:
Other - First Name:NETTECHA
Other - Middle Name:
Other - Last Name:RHEINGOLD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:114 E OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:FL
Mailing Address - Zip Code:33462-3206
Mailing Address - Country:US
Mailing Address - Phone:561-557-7978
Mailing Address - Fax:
Practice Address - Street 1:114 E OCEAN AVE
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:FL
Practice Address - Zip Code:33462-3206
Practice Address - Country:US
Practice Address - Phone:561-557-7978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLC54004224900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1932862174OtherNPI