Healthcare Provider Details

I. General information

NPI: 1578558656
Provider Name (Legal Business Name): RACHEL K CIACCIO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6859 SW 18TH ST STE 200
BOCA RATON FL
33433
US

IV. Provider business mailing address

6859 SW 18TH ST STE 200
BOCA RATON FL
33433
US

V. Phone/Fax

Practice location:
  • Phone: 561-368-3775
  • Fax: 561-392-7139
Mailing address:
  • Phone: 561-368-3775
  • Fax: 561-392-7139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME103868
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: