Healthcare Provider Details

I. General information

NPI: 1942334446
Provider Name (Legal Business Name): RAFAEL E ESCABI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AVENUE FLAMBOYAN NO. 237
LAJAS PR
00667-0583
US

IV. Provider business mailing address

CARR 306 KM 4.1 BO PARIS
LAJAS PR
00667-0583
US

V. Phone/Fax

Practice location:
  • Phone: 787-899-4242
  • Fax: 787-899-8023
Mailing address:
  • Phone: 787-899-4242
  • Fax: 787-899-8023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8831
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: