Provider Demographics
NPI:1841288990
Name:MAPA, RITA T (MD)
Entity type:Individual
Prefix:DR
First Name:RITA
Middle Name:T
Last Name:MAPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RITA
Other - Middle Name:B
Other - Last Name:TANCHULING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4930 E LAKE MARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-5003
Mailing Address - Country:US
Mailing Address - Phone:407-322-8645
Mailing Address - Fax:407-324-7311
Practice Address - Street 1:6101 LAKE ELLENOR DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809
Practice Address - Country:US
Practice Address - Phone:407-322-8645
Practice Address - Fax:407-956-4676
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83031208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262409500Medicaid
591741286OtherTRICARE
FL01237329OtherAMERIGROUP
FL262409500Medicaid
FL515431OtherWELLCARE