Provider Demographics
NPI:1871743112
Name:RACHLES, DEBORAH SUSAN (RD)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SUSAN
Last Name:RACHLES
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N ARCADIA AVENUE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266
Mailing Address - Country:US
Mailing Address - Phone:863-990-1867
Mailing Address - Fax:
Practice Address - Street 1:1500 N ARCADIA AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266-8820
Practice Address - Country:US
Practice Address - Phone:863-990-1867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND4687133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLND4687OtherLICENSED DIETITIAN FLORIDA
726120OtherAMERICAN DIETITIC ASSOCIATION