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NPI Code Detail

MEDICARE: DR. RACHAEL STREETER O.D.

MEDICARE: DR. RACHAEL STREETER O.D.
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
1152W00000XOptometristOPC3706FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16599535OTHERFLGHI
220086OTHERFLBCBS
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255325478
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RACHAEL STREETER O.D.
Provider Business Mailing Address
First Line : 43309 US HIGHWAY 19 N
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-6221
Country : US
Telephone Number : 727-943-3111
Fax Number : 727-943-3334
Provider Business Practice Location Address
First Line : 43309 US HIGHWAY 19 N
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-6221
Country : US
Telephone Number : 727-943-3111
Fax Number : 727-943-3334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2005
Last Update Date : 04/16/2008

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