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General NPI Number Information
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NPI Number | 1609841824
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Entity Type | Individual
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Provider Name | JORGE RAFAEL RABAZA MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 6200 SW 72ND ST STE 502
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City | SOUTH MIAMI
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State | FL
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Zip | 33143-4830
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Country | US
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Telephone | 305-271-9777
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Fax | 305-533-9450
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Provider Business Mailing Address
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Address Line | PO BOX 198054
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City | ATLANTA
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State | GA
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Zip | 30384-8054
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Country | US
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Telephone | 305-271-9777
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME0057346
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License Number State | FL
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