MEDICARE: NEAL E RAKOV MD

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	207RG0100X	Gastroenterology Physician	ME73295	FL
2	207RG0100X	Gastroenterology Physician	89-90	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	41544	OTHER	FL	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	850372521	OTHER	FL	CHAMPUS

General Provider Information

NPI Number	:	1528006806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEAL E RAKOV MD

Provider Business Mailing Address
First Line	:	91550 OVERSEAS HIGHWAY
Second Line	:	SUITE 215
City	:	TAVERNIER
State	:	FL
Zip	:	33070-2141
Country	:	US
Telephone Number	:	305-852-9400
Fax Number	:	305-852-6457

Provider Business Practice Location Address
First Line	:	933 BRADBURY DR SE STE 2222
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-4375
Country	:	US
Telephone Number	:	505-272-3120
Fax Number	:	505-272-8060

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	11/27/2018

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Directions to “ NEAL E RAKOV MD” Practice Location

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