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General NPI Number Information
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NPI Number | 1255774725
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Entity Type | Individual
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Provider Name | RAFAEL A COUTO CUERVO MD
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Gender | Male
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Dates
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Enumeration Date | 04/15/2013
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 373 CALLE SAN JORGE STE 200
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City | SAN JUAN
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State | PR
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Zip | 00912-3312
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Country | US
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Telephone | 787-671-0416
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Fax |
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Provider Business Mailing Address
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Address Line | 373 CALLE SAN JORGE STE 200
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City | SAN JUAN
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State | PR
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Zip | 00912-3312
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Country | US
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Telephone | 787-422-0004
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | R9739
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 21271
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License Number State | PR
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 35.131784
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License Number State | OH
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