Organization Active NPI

Dean L Rackleff MD PA

  • Infectious Disease Physician
  • Bonita Springs, FL
National Provider Identifier
1114178340
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
ME0069187 Issued in FL
Legal business name
DEAN L RACKLEFF MD PA
Practice address
9400 Bonita Beach Rd SE Ste 102
Bonita Springs, FL 34135-4520
Phone
(239) 455-9946
Fax
(239) 455-9947
NPI assigned
Oct 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dean Lawrence Rackleff, MD
Title
President
Phone
(239) 455-9946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X ME0069187 FL Primary

Addresses

Primary practice location

9400 Bonita Beach Rd SE Ste 102
Bonita Springs, FL 34135-4520

Mailing address

9400 Bonita Beach Road
Suite 102
Bonita Springs, FL 34135
Phone (239) 455-9946

Other identifiers 1

IdentifierTypeStateIssuer
378687100MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1114178340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 BONITA BEACH ROAD",
            "address_2": "SUITE 102",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "34135",
            "telephone_number": "239-455-9946",
            "fax_number": "239-455-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 BONITA BEACH RD SE STE 102",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341354520",
            "telephone_number": "239-455-9946",
            "fax_number": "239-455-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN L RACKLEFF MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "RACKLEFF",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-455-9946",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "FL",
            "license": "ME0069187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378687100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonita Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.