Healthcare Provider Details

I. General information

NPI: 1033741491
Provider Name (Legal Business Name): RACHEL KRISTEN MORIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2020
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 STATE ROAD 54 STE 108
TRINITY FL
34655-2263
US

IV. Provider business mailing address

14020 SE 106TH ST
OCKLAWAHA FL
32179-4266
US

V. Phone/Fax

Practice location:
  • Phone: 727-376-4040
  • Fax:
Mailing address:
  • Phone: 352-430-4120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11005284
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1005284
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: