DR. DMITRY RAKITA (NPI# 1487826624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487826624 |
| Entity Type | Individual |
| Full Name | DR. DMITRY RAKITA |
| Credential | M.D. |
| Practice Address |
1350 Hickory Street Melbourne FL 32901-3224 |
| Mailing Address |
Po Box 2400 Melbourne FL 32902-2400 |
| Practice Telephone | 3214347000 |
| Practice Fax Number | 2037853061 |
| Mailing Telephone | 3218373820 |
| Mailing Fax Number | 2037371688 |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2020-09-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME124760 | FL | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
046203 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | FL MEDICARE | IL499Y | 01 |
| FL | 016431500 | 05 |
| Street Address |
1350 HICKORY STREET |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760694285 | Michael Wayne Chen | Radiology | 1350 Hickory Street, Melbourne, FL 32901-3224 | 2007-05-04 |
| 1669708715 | Jason Joseph Redon | Radiology | 1350 Hickory Street, Melbourne, FL 32901-3224 | 2009-10-26 |
| 1205079506 | Andre T Graves | Radiology | 1350 Hickory Street, Melbourne, FL 32901-3224 | 2009-04-16 |
| 1770743908 | Gregory Benke | Radiology | 1350 Hickory Street, Melbourne, FL 32901-3224 | 2008-06-11 |
| 1063613180 | Charles Ehlenberger | Radiology | 1350 Hickory Street, Melbourne, FL 32901-3224 | 2007-05-29 |
| 1649488420 | Anoop K Palta | Pediatrics | 1350 Hickory Street, Holmes Regional Medical Center, Melbourne, FL 32901 | 2007-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225592041 | Central Florida Radiology LLC | Radiology | Standup Mri of Brevrd, 6023 Farcenda Place - Suite 101, Melbourne, FL 32940-7340 | 2019-01-25 |
| 1235365578 | Chad Phillip Berlin | Radiology | 1775 W Hibiscus Blvd Ste 215, Melbourne, FL 32901-2627 | 2009-06-01 |
| 1750522678 | David Raymond Autry | Radiology | 3830 S Hwy A1a # 4-160, Melbourne, FL 32951-3143 | 2009-03-24 |
| 1487851812 | Temoor Sajjad Anwar | Radiology | 765 W Nasa Blvd, Melbourne, FL 32901-1815 | 2007-06-29 |
| 1760694285 | Michael Wayne Chen | Radiology | 1350 Hickory Street, Melbourne, FL 32901-3224 | 2007-05-04 |
| 1710902812 | Alan K Marumoto | Radiology | 1800 W. Hibiscus Blvd, Suite 100, Melbourne, FL 32901-2629 | 2006-07-12 |
| 1033165865 | David Samuel Epstein | Radiology | 1775 W Hibiscus Blvd, Ste 215, Melbourne, FL 32901-2620 | 2006-05-25 |
| 1366419384 | Brian H Breslaw | Radiology | 1350 South Hickory Street, Holmes Regional Medical Center/radiology, Melbourne, FL 32901-3278 | 2006-03-08 |
| 1437147311 | Harbor City Medical Imaging Pa | Radiology | 1920 S Babcock St, Melbourne, FL 32901-4445 | 2005-10-13 |
| 1275521163 | Thomas R Foster | Radiology | 709 S Harbor City Blvd, Suite 100, Melbourne, FL 32901-1938 | 2005-10-13 |
| Find all providers in MELBOURNE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.