Provider Demographics
NPI:1609239292
Name:JEAN-CLAUDE, RACHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:L
Last Name:JEAN-CLAUDE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RACHAEL
Other - Middle Name:L
Other - Last Name:SCIPLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2995 DREW ST FL 2
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-3012
Mailing Address - Country:US
Mailing Address - Phone:727-532-1355
Mailing Address - Fax:813-635-2613
Practice Address - Street 1:12780 RACE TRACK RD STE 400
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33626-1395
Practice Address - Country:US
Practice Address - Phone:813-321-6262
Practice Address - Fax:813-443-8150
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME135671207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103921300Medicaid