Provider Demographics
NPI:1548425788
Name:DITRAPANI, RACHEL ABIGAIL (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ABIGAIL
Last Name:DITRAPANI
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 1:3 SHIRCLIFF WAY
Mailing Address - Street 2:SUITE 724
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4786
Mailing Address - Country:US
Mailing Address - Phone:904-308-7959
Mailing Address - Fax:904-308-7938
Practice Address - Street 1:3 SHIRCLIFF WAY
Practice Address - Street 2:SUITE 724
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4786
Practice Address - Country:US
Practice Address - Phone:904-308-7959
Practice Address - Fax:904-308-7938
Is Sole Proprietor?:No
Enumeration Date:2008-07-28
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1023412084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
14M3LOtherBCBS-FL
FL006373200Medicaid
FLP01085558OtherRAILROAD MEDICARE
FL356723OtherAVMED
FLP01085558OtherRAILROAD MEDICARE