Healthcare Provider Details

I. General information

NPI: 1750134748
Provider Name (Legal Business Name): RAFAEL AQUINO HERNANDEZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 CALLE 65 INFANTERIA
ANASCO PR
00610-2902
US

IV. Provider business mailing address

36 CALLE 65 INFANTERIA
ANASCO PR
00610-2902
US

V. Phone/Fax

Practice location:
  • Phone: 787-934-8737
  • Fax:
Mailing address:
  • Phone: 787-934-8737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RAFAEL AQUINO HERNANDEZ
Title or Position: PREESIDENT
Credential: MD
Phone: 787-934-8737