Healthcare Provider Details

I. General information

NPI: 1265769822
Provider Name (Legal Business Name): RAFAEL ABREU M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2009
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 W 49TH PL STE 500
HIALEAH FL
33012-3158
US

IV. Provider business mailing address

1490 W 49TH PL STE 204
HIALEAH FL
33012-3149
US

V. Phone/Fax

Practice location:
  • Phone: 305-392-0380
  • Fax: 305-603-9683
Mailing address:
  • Phone: 305-392-0380
  • Fax: 305-603-9683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME109733
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME109733
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: