Individual
DEREK RACHELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2323 S ORANGE AVE, ORLANDO, FL 32806-3059
(407) 418-9999
Mailing address
519 WHEATSTONE PL, ORLANDO, FL 32835-4450
(407) 432-0729
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104016
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2930749-00
—
FL
Enumeration date
12/02/2006
Last updated
12/21/2023
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