Provider Demographics
NPI:1740294677
Name:RACHMAN, NATHAN (MD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:RACHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1329 SW 16TH ST RM 2232
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-1128
Mailing Address - Country:US
Mailing Address - Phone:352-733-0485
Mailing Address - Fax:
Practice Address - Street 1:1241 KILLARNEY DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-2828
Practice Address - Country:US
Practice Address - Phone:386-451-2975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0065917207L00000X
FLME65917207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL375166000Medicaid
FL25163XMedicare PIN
FL25163ZMedicare ID - Type Unspecified
FLF78245Medicare UPIN