Healthcare Provider Details

I. General information

NPI: 1669853974
Provider Name (Legal Business Name): RACHEL CASANAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 W 46TH ST APT 230
HIALEAH FL
33012-2880
US

IV. Provider business mailing address

1750 W 46TH ST APT 230
HIALEAH FL
33012-2880
US

V. Phone/Fax

Practice location:
  • Phone: 786-296-8650
  • Fax:
Mailing address:
  • Phone: 786-296-8650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSS1976
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: