Individual
RACHEL BEVERLY TALLBACKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A..
Contact information
Practice address
13945 N US HIGHWAY 441, LADY LAKE, FL 32159-8924
(352) 277-3500
(352) 277-3498
Mailing address
206 W ROCKWELL AVE, STE 100, SOLDOTNA, AK 99669-7439
(907) 262-7566
(907) 262-0809
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
2348
AK
363AM0700X
Medical Physician Assistant
Primary
PA1905
FL
Other
Enumeration date
07/11/2006
Last updated
10/17/2019
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