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General NPI Number Information
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NPI Number | 1174164909
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Entity Type | Individual
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Provider Name | RAFAEL JOSE BERNAL RPA
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Gender | Male
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 01/27/2020
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Provider Practice Location Address
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Address Line | 8900 N KENDALL DR
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City | MIAMI
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State | FL
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Zip | 33176-2118
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Country | US
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Telephone | 786-596-5959
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 CONCORD TER
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City | SUNRISE
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State | FL
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Zip | 33323-2843
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 243U00000X
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Taxonomy Name | Radiology Practitioner Assistant
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License Number | 11FL1443
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | CRT71452
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License Number State | FL
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