MEDICARE: DAMARYS ROSA RABELO

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	363LF0000X	Family Nurse Practitioner	0024195458	VA
2	363LF0000X	Family Nurse Practitioner	3-002076	AL
3	363LF0000X	Family Nurse Practitioner	GAA-NP003298	GA
4	363LF0000X	Family Nurse Practitioner	1191336	TX
5	363LF0000X	Family Nurse Practitioner	116530	NE
6	363LF0000X	Family Nurse Practitioner	14260747-4405	UT
7	363LF0000X	Family Nurse Practitioner	AP61639597	WA
8	363LF0000X	Family Nurse Practitioner	29749	SC
9	363LF0000X	Family Nurse Practitioner	0038191	OH
10	363LF0000X	Family Nurse Practitioner	318513	AZ
11	363LF0000X	Family Nurse Practitioner	APRN9356725	FL
12	363LF0000X	Family Nurse Practitioner	LG-0013546	DE
13	363LF0000X	Family Nurse Practitioner	320648	AZ
14	363LF0000X	Family Nurse Practitioner	4031615	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP9356725	OTHER	FL	FLORIDA DEPARTMENT OF HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427564483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAMARYS ROSA RABELO

Provider Business Mailing Address
First Line	:	PO BOX 211699
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55121-3699
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 HOWELL MILL RD NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30318-5557
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:

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

Provider Enumeration Date	:	12/28/2017
Last Update Date	:	12/11/2025

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