Healthcare Provider Details

I. General information

NPI: 1619068384
Provider Name (Legal Business Name): JOSEPH C RASHKIN M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4726 N HABANA AVE STE 204
TAMPA FL
33614
US

IV. Provider business mailing address

504 N REO ST
TAMPA FL
33609-1013
US

V. Phone/Fax

Practice location:
  • Phone: 813-682-0347
  • Fax:
Mailing address:
  • Phone: 813-549-2134
  • Fax: 813-877-8548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME40192
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: