Healthcare Provider Details

I. General information

NPI: 1376770362
Provider Name (Legal Business Name): RACHEL-MARIE ANNIETA CAZEAU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 E PRINCETON ST STE 101
ORLANDO FL
32803-1435
US

IV. Provider business mailing address

615 E PRINCETON ST STE 101
ORLANDO FL
32803-1435
US

V. Phone/Fax

Practice location:
  • Phone: 407-896-2901
  • Fax: 407-896-2902
Mailing address:
  • Phone: 407-896-2901
  • Fax: 407-896-2902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125056973
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number35.098636
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberME123684
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: