MEDICARE: PATRICIA RAPPLEAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1164007621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA RAPPLEAN

Provider Business Mailing Address
First Line	:	157 BROADHAVEN DR
Second Line	:
City	:	PONTE VEDRA
State	:	FL
Zip	:	32081-0926
Country	:	US
Telephone Number	:	954-224-7822
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 WELLS RD STE 203
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-3036
Country	:	US
Telephone Number	:	904-269-3522
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2021
Last Update Date	:	03/16/2021

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Directions to “ PATRICIA RAPPLEAN ” Practice Location

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