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General NPI Number Information
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NPI Number | 1457309288
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Entity Type | Individual
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Provider Name | RAFAEL A ANTUN MD
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Gender | Male
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 7600 SW 57 AVE STE 213
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5408
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Country | US
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Telephone | 305-548-4005
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Fax | 305-548-4055
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Provider Business Mailing Address
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Address Line | 7600 SW 57 AVE STE 213
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-5408
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Country | US
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Telephone | 305-548-4005
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Fax | 305-548-4055
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME0059386
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | ME59386
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License Number State | FL
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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 | ME59386
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License Number State | FL
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