Provider Demographics
NPI:1568197366
Name:CANIZARES, RACHEL C (APRN)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:C
Last Name:CANIZARES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WOODMERE CT
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33761-3242
Mailing Address - Country:US
Mailing Address - Phone:727-744-0778
Mailing Address - Fax:
Practice Address - Street 1:12420 130TH AVE N
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-1919
Practice Address - Country:US
Practice Address - Phone:727-824-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-18
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020169363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care