MEDICARE: DR. RAFAEL H ZARAGOZA URDAZ M.D., PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	11589	PR

General Provider Information

NPI Number	:	1023166055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAFAEL H ZARAGOZA URDAZ M.D., PH.D.

Provider Business Mailing Address
First Line	:	317 AVE MANUEL DOMENECH
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3511
Country	:	US
Telephone Number	:	787-764-5715
Fax Number	:	787-764-3709

Provider Business Practice Location Address
First Line	:	317 AVE MANUEL DOMENECH
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3511
Country	:	US
Telephone Number	:	787-764-5715
Fax Number	:	787-764-3709

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	12/10/2022

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