Provider Demographics
NPI:1578558656
Name:CIACCIO, RACHEL K (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:K
Last Name:CIACCIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6853 SW 18TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-7056
Mailing Address - Country:US
Mailing Address - Phone:561-368-3775
Mailing Address - Fax:561-368-1143
Practice Address - Street 1:6853 SW 18TH ST STE 301
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7056
Practice Address - Country:US
Practice Address - Phone:561-368-3775
Practice Address - Fax:561-368-1143
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL103868207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI7010442Medicaid
CT003117711Medicaid
RIH85653Medicare UPIN
RI7010442Medicaid
CT003117711Medicaid