MEDICARE: RAFAEL HEALTH SERVICES INC

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
1	261QM1300X	Multi-Specialty Clinic/Center	HCC4291	FL

General Provider Information

NPI Number	:	1922058692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAFAEL HEALTH SERVICES INC

Provider Business Mailing Address
First Line	:	16378 NE 26TH AVE
Second Line	:
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33160-4004
Country	:	US
Telephone Number	:	305-940-0040
Fax Number	:	305-940-0094

Provider Business Practice Location Address
First Line	:	16378 NE 26TH AVE
Second Line	:
City	:	N MIAMI BEACH
State	:	FL
Zip	:	33160-4004
Country	:	US
Telephone Number	:	305-940-0040
Fax Number	:	305-940-0094

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ALEX KROYTOR
Credential	:
Telephone Number	:	305-940-0040

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	09/05/2007

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Directions to “RAFAEL HEALTH SERVICES INC ” Practice Location

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