Healthcare Provider Details

I. General information

NPI: 1790263457
Provider Name (Legal Business Name): RACHAEL L RAGHUNANDAN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 MAJORCA PL APT 5034
ORLANDO FL
32819-5560
US

IV. Provider business mailing address

13695 SW 99TH ST
MIAMI FL
33186-2807
US

V. Phone/Fax

Practice location:
  • Phone: 305-282-2235
  • Fax:
Mailing address:
  • Phone: 305-282-2235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9338220
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60872404
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: