Provider Demographics
NPI:1841841442
Name:NEBENZAHL, RACHEL LAUREN (PA-C)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:LAUREN
Last Name:NEBENZAHL
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:15280 NW 79TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5873
Mailing Address - Country:US
Mailing Address - Phone:305-558-3724
Mailing Address - Fax:786-907-4485
Practice Address - Street 1:10150 HAGEN RANCH RD STE 100
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3776
Practice Address - Country:US
Practice Address - Phone:561-736-8141
Practice Address - Fax:561-736-5662
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-25
Last Update Date:2023-05-25
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Provider Licenses
StateLicense IDTaxonomies
FLPA9112592363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant