Healthcare Provider Details

I. General information

NPI: 1821518721
Provider Name (Legal Business Name): RAYLI C PICHARDO PERNALETE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST WHITNEY HENDRICKSON BLDG STE 134
LEXINGTON KY
40536-2610
US

IV. Provider business mailing address

800 ROSE ST WHITNEY HENDRICKSON BLDG STE 134
LEXINGTON KY
40536-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-2650
  • Fax: 859-323-0702
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301511831
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125070620
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number4301511831
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number60706
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number4301511831
License Number StateMI
# 6
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number4301511831
License Number StateMI
# 7
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number60706
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: