Provider Demographics
NPI:1780058990
Name:RABAZINSKI, MAUREEN ANN (APRN)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:RABAZINSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7000 SPYGLASS CT STE 501
Mailing Address - Street 2:
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8288
Mailing Address - Country:US
Mailing Address - Phone:321-247-7063
Mailing Address - Fax:321-222-5256
Practice Address - Street 1:7000 SPYGLASS CT.
Practice Address - Street 2:STE. 130
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-4103
Practice Address - Country:US
Practice Address - Phone:321-247-7063
Practice Address - Fax:321-222-5256
Is Sole Proprietor?:No
Enumeration Date:2015-11-25
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1632562363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
7041977OtherCIGNA
FL016805700Medicaid
FLFWFXQOtherFLORIDA BLUE