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General NPI Number Information
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NPI Number | 1568221240
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Entity Type | Individual
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Provider Name | RACHEL MEDEROS BADA
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Gender | Female
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Dates
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Enumeration Date | 03/15/2024
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 10075 S JOG RD STE 201
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-3536
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Country | US
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Telephone | 561-733-1012
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Fax |
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Provider Business Mailing Address
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Address Line | 721 NE 51ST CT
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-4851
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Country | US
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Telephone | 954-470-7813
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Fax |
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OAT19802
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License Number State | FL
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