MEDICARE: RACHAEL FERRO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1104487131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL FERRO

Provider Business Mailing Address
First Line	:	3824 HIDEAWAY LN
Second Line	:
City	:	MIDDLEBURG
State	:	FL
Zip	:	32068-3867
Country	:	US
Telephone Number	:	352-318-4354
Fax Number	:

Provider Business Practice Location Address
First Line	:	4665 JULINGTON CREEK RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32258-2144
Country	:	US
Telephone Number	:	904-376-0784
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	10/29/2024

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