Healthcare Provider Details

I. General information

NPI: 1477964195
Provider Name (Legal Business Name): INESSA RACHEL BACHOVE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INESSA RACHEL SIMANOVICH

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 N FLAGLER DR STE 4100
WEST PALM BEACH FL
33401-3436
US

IV. Provider business mailing address

840 US HIGHWAY 1 STE 235
NORTH PALM BEACH FL
33408-3835
US

V. Phone/Fax

Practice location:
  • Phone: 561-626-2006
  • Fax: 561-626-8622
Mailing address:
  • Phone: 561-626-2006
  • Fax: 561-626-8622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number05017039
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number05017039
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberOS13953
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS13953
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: