MEDICARE: DR. RACHEL S EIDELMAN M.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
1	207RC0000X	Cardiovascular Disease Physician	ME82175	FL

General Provider Information

NPI Number	:	1518941012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RACHEL S EIDELMAN M.D.

Provider Business Mailing Address
First Line	:	10301 HAGEN RANCH RD
Second Line	:	SUITE B-5
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3724
Country	:	US
Telephone Number	:	561-244-7720
Fax Number	:	561-244-7724

Provider Business Practice Location Address
First Line	:	10301 HAGEN RANCH RD
Second Line	:	SUITE B-5
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3724
Country	:	US
Telephone Number	:	561-244-7720
Fax Number	:	561-244-7724

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	04/14/2010

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