Provider Demographics
NPI:1801474838
Name:DYKES, RACHEL
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:DYKES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-4120
Mailing Address - Country:US
Mailing Address - Phone:904-541-0315
Mailing Address - Fax:904-541-0316
Practice Address - Street 1:906 PARK AVE
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-4120
Practice Address - Country:US
Practice Address - Phone:904-541-0315
Practice Address - Fax:904-541-0316
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS22342207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology