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General NPI Number Information
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NPI Number | 1790095479
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Entity Type | Individual
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Provider Name | RACHEL MARIA REID PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2010
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1001 COLLEGE BLVD W STE I
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City | NICEVILLE
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State | FL
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Zip | 32578-1049
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Country | US
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Telephone | 850-842-4563
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Fax | 850-842-4606
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Provider Business Mailing Address
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Address Line | 104 LAS ROBLAS GRANDE DR
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-2603
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Country | US
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Telephone | 270-519-6773
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA08626
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA968
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9107878
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9107878
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License Number State | FL
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