Provider Demographics
NPI:1508167628
Name:BAERGA-DUPEROY, RACHEL (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BAERGA-DUPEROY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:BAERGA-DUPEROY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-628-3192
Mailing Address - Fax:407-647-5431
Practice Address - Street 1:9981 S HEALTHPARK DR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3618
Practice Address - Country:US
Practice Address - Phone:239-628-3192
Practice Address - Fax:407-647-5431
Is Sole Proprietor?:No
Enumeration Date:2010-11-05
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10012017207R00000X
TXR7654207R00000X
NY266723207R00000X, 208M00000X
NH16892207R00000X
MEMD26197207R00000X
FLME114741208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103104600Medicaid