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NPI Code Detail

MEDICARE: RAFAEL BURGOS JR. MD

MEDICARE: RAFAEL BURGOS JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME055838FL
2207Q00000XFamily Medicine Physician29086NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1346203742
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAFAEL BURGOS JR. MD
Provider Business Mailing Address
First Line : 3131 SW 112TH AVE
Second Line :
City : MIAMI
State : FL
Zip : 33165-2223
Country : US
Telephone Number : 786-763-9576
Fax Number :
Provider Business Practice Location Address
First Line : 1501 W SUNSET RD
Second Line :
City : HENDERSON
State : NV
Zip : 89014-6636
Country : US
Telephone Number : 125-269-7001
Fax Number : 725-712-8165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2006
Last Update Date : 04/07/2026

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Directions to “ RAFAEL BURGOS JR. MD” Practice Location

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