Healthcare Provider Details

I. General information

NPI: 1376483859
Provider Name (Legal Business Name): RACHAEL L KANE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 WINTER GARDEN VINELAND RD STE 208
WINDERMERE FL
34786-6098
US

IV. Provider business mailing address

5151 WINTER GARDEN VINELAND RD STE 208
WINDERMERE FL
34786-6098
US

V. Phone/Fax

Practice location:
  • Phone: 407-612-4007
  • Fax: 407-612-4017
Mailing address:
  • Phone: 407-612-4007
  • Fax: 407-612-4017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN11046436
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11046436
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: