Healthcare Provider Details

I. General information

NPI: 1740184407
Provider Name (Legal Business Name): RAFAELA PEREZ SOSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8930 SW 25TH ST
MIAMI FL
33165-2021
US

IV. Provider business mailing address

8930 SW 25TH ST
MIAMI FL
33165-2021
US

V. Phone/Fax

Practice location:
  • Phone: 305-951-8436
  • Fax:
Mailing address:
  • Phone: 305-951-8436
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number003304
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: