Provider Demographics
NPI:1639488141
Name:RACHBIND, JESSICA LYNNE (PA-C)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNNE
Last Name:RACHBIND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNNE
Other - Last Name:DUMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:10970 NW 17TH PLACE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071
Mailing Address - Country:US
Mailing Address - Phone:954-536-4597
Mailing Address - Fax:561-852-7611
Practice Address - Street 1:8190 ROYAL PALM BLVD, STE 100
Practice Address - Street 2:HOLY CROSS MEDICAL GROUP EAST CORAL SPRINGS
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:954-344-2288
Practice Address - Fax:954-344-8443
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105683363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEK201ZMedicare PIN