Healthcare Provider Details

I. General information

NPI: 1841845658
Provider Name (Legal Business Name): RACHAEL M HAMELINK AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2019
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 PINE ST STE 211
ENGLEWOOD FL
34223-4458
US

IV. Provider business mailing address

900 PINE ST STE 211
ENGLEWOOD FL
34223-4458
US

V. Phone/Fax

Practice location:
  • Phone: 941-473-8881
  • Fax: 941-475-0801
Mailing address:
  • Phone: 941-473-8881
  • Fax: 941-475-0801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11025971
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: