Provider Demographics
NPI:1851399885
Name:RASHKIN, JACK EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JACK
Middle Name:EDWARD
Last Name:RASHKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1840 MEASE DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-6602
Mailing Address - Country:US
Mailing Address - Phone:727-725-6128
Mailing Address - Fax:727-725-6168
Practice Address - Street 1:1840 MEASE DR
Practice Address - Street 2:SUITE 400
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6602
Practice Address - Country:US
Practice Address - Phone:727-725-6128
Practice Address - Fax:727-725-6168
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME46236207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL044628900Medicaid
FL044628900Medicaid
FL02219UMedicare PIN