Healthcare Provider Details

I. General information

NPI: 1023543121
Provider Name (Legal Business Name): RACHNA BUXANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2017
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12651 S DIXIE HWY STE 402
PINECREST FL
33156-5956
US

IV. Provider business mailing address

9270 SW 93RD AVE
MIAMI FL
33176-2040
US

V. Phone/Fax

Practice location:
  • Phone: 305-587-8482
  • Fax:
Mailing address:
  • Phone: 305-587-8482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 14983
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: