Provider Demographics
NPI:1790095479
Name:REID, RACHEL MARIA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:MARIA
Last Name:REID
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:104 LAS ROBLAS GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-2603
Mailing Address - Country:US
Mailing Address - Phone:270-519-6773
Mailing Address - Fax:
Practice Address - Street 1:91 SCENIC GULF DR STE 200
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-4951
Practice Address - Country:US
Practice Address - Phone:850-496-8946
Practice Address - Fax:850-460-8945
Is Sole Proprietor?:No
Enumeration Date:2010-10-15
Last Update Date:2018-04-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA08626363A00000X
ALPA968363A00000X
FLPA9107878363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant