Provider Demographics
NPI:1144370891
Name:AOUCHICHE, RACHID (MD)
Entity type:Individual
Prefix:
First Name:RACHID
Middle Name:
Last Name:AOUCHICHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15640 NEW HAMPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4168
Mailing Address - Country:US
Mailing Address - Phone:239-466-3111
Mailing Address - Fax:239-466-9499
Practice Address - Street 1:15640 NEW HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4168
Practice Address - Country:US
Practice Address - Phone:239-466-3111
Practice Address - Fax:239-466-9499
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0052959207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05731ZOtherBLUE CROSS
605440OtherAETNA
FL048619100Medicaid
FL4807300001Medicare NSC
FL05731Medicare PIN
FLB70131Medicare UPIN