Individual
MS. RACHEL MARIE FLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3001 W DR MARTIN LUTHER KING JR BLVD, TAMPA, FL 33607-6307
(813) 870-4619
(813) 554-8496
Mailing address
3001 W DR MLK BLVD, TAMPA, FL 33607-6307
(813) 554-8527
(813) 554-8496
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9110663
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022800900
—
FL
Enumeration date
10/04/2017
Last updated
04/03/2023
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