Healthcare Provider Details

I. General information

NPI: 1255837134
Provider Name (Legal Business Name): HUGO FLAVIO RAPOSO JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2018
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 NEPONSET ST
WORCESTER MA
01606-2714
US

IV. Provider business mailing address

5 NEPONSET ST
WORCESTER MA
01606-2714
US

V. Phone/Fax

Practice location:
  • Phone: 508-595-2855
  • Fax:
Mailing address:
  • Phone: 508-595-2855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number289127
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: