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General NPI Number Information
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NPI Number | 1285785139
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Entity Type | Individual
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Provider Name | DEAN L RACKLEFF M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 10/04/2012
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Provider Practice Location Address
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Address Line | 3467 PINE RIDGE RD 103
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City | NAPLES
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State | FL
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Zip | 34109-3832
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Country | US
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Telephone | 239-455-9946
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Fax | 239-455-9947
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Provider Business Mailing Address
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Address Line | 3467 PINE RIDGE RD STE 103
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City | NAPLES
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State | FL
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Zip | 34109-3832
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Country | US
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Telephone | 239-455-9946
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Fax | 239-455-9947
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME0069187
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License Number State | FL
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