Healthcare Provider Details

I. General information

NPI: 1912836776
Provider Name (Legal Business Name): RACHEL CERVONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 NW 21ST AVE
OCALA FL
34475-4999
US

IV. Provider business mailing address

2150 NW 21ST AVE
OCALA FL
34475-4999
US

V. Phone/Fax

Practice location:
  • Phone: 631-875-1817
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9675727
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: