Healthcare Provider Details

I. General information

NPI: 1568197366
Provider Name (Legal Business Name): RACHEL C CANIZARES APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2022
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 4TH ST N STE 8827
ST PETERSBURG FL
33702-4305
US

IV. Provider business mailing address

7901 4TH ST N STE 8827
ST PETERSBURG FL
33702-4305
US

V. Phone/Fax

Practice location:
  • Phone: 813-692-9896
  • Fax:
Mailing address:
  • Phone: 813-692-9896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPRN11020169
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: