Provider Demographics
NPI:1932540929
Name:RACHMAN, CARLY (DOM, AP)
Entity Type:Individual
Prefix:DR
First Name:CARLY
Middle Name:
Last Name:RACHMAN
Suffix:
Gender:F
Credentials:DOM, AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15830 W STATE ROAD 84
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1212
Mailing Address - Country:US
Mailing Address - Phone:954-389-5507
Mailing Address - Fax:
Practice Address - Street 1:15830 W STATE ROAD 84
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33326-1212
Practice Address - Country:US
Practice Address - Phone:954-389-5507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3292171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist