Provider Demographics
NPI:1003255985
Name:NAMBUSI, RACHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:
Last Name:NAMBUSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1717 N BAYSHORE DR # R230
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1103
Mailing Address - Country:US
Mailing Address - Phone:305-744-4922
Mailing Address - Fax:217-771-1814
Practice Address - Street 1:1717 N BAYSHORE DR # R230
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1103
Practice Address - Country:US
Practice Address - Phone:305-744-4922
Practice Address - Fax:217-771-1814
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-24
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-127380207Q00000X
ARE- 9261207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine