Provider Demographics
NPI:1932178472
Name:ADAMS, REBECCA JOANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:JOANNE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:790 CONCOURSE PKWY SOUTH
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751
Mailing Address - Country:US
Mailing Address - Phone:407-767-6411
Mailing Address - Fax:407-767-8160
Practice Address - Street 1:790 CONCOURSE PKWY SOUTH
Practice Address - Street 2:SUITE 200
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751
Practice Address - Country:US
Practice Address - Phone:407-767-6411
Practice Address - Fax:407-767-8160
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME110617207W00000X, 207WX0110X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0110XAllopathic & Osteopathic PhysiciansOphthalmologyPediatric Ophthalmology and Strabismus Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59-3490927OtherTIN
D06895Medicare UPIN
GAD06895Medicare UPIN
GA5739068OtherAETNA
GA010600752OtherUNITED HEALTHCARE
GA000544981AMedicaid