Individual
DR. RACHEL KOMALA MOODEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4129 N ARMENIA AVE, TAMPA, FL 33607-6436
(813) 879-3699
(813) 873-8469
Mailing address
4129 N ARMENIA AVE, TAMPA, FL 33607-6436
(813) 879-3699
(813) 873-8469
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME106024
FL
207RP1001X
Pulmonary Disease Physician
ME106024
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003490300
—
FL
01
—
1486A
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/08/2007
Last updated
01/15/2021
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