Provider Demographics
NPI:1871903096
Name:SPRAGUE, RACHEL GRIMES (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:GRIMES
Last Name:SPRAGUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9600 BLACKWELL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3783
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:844-487-7727
Practice Address - Street 1:2590 HEALING WAY STE 160
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-5497
Practice Address - Country:US
Practice Address - Phone:813-321-0146
Practice Address - Fax:855-867-6703
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME137234207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program