MEDICARE: RACHAEL KIMBERLYN JAMES

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	101YS0200X	School Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124740188
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL KIMBERLYN JAMES

Provider Business Mailing Address
First Line	:	3504 N LECANTO HWY STE D
Second Line	:
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3504 N LECANTO HWY
Second Line	:	STE D
City	:	BEVERLY HILLS
State	:	FL
Zip	:	34465
Country	:	US
Telephone Number	:	352-419-4856
Fax Number	:

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

Provider Enumeration Date	:	09/16/2022
Last Update Date	:	09/16/2022

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