MEDICARE: DR. RAFAEL XAVIER RODRIGUEZ-WERNER DMD

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	122300000X	Dentist	2093	PR

General Provider Information

NPI Number	:	1194712281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAFAEL XAVIER RODRIGUEZ-WERNER DMD

Provider Business Mailing Address
First Line	:	PO BOX 143636
Second Line	:
City	:	ARECIBO
State	:	PR
Zip	:	00614-3636
Country	:	US
Telephone Number	:	787-740-1919
Fax Number	:	787-650-3584

Provider Business Practice Location Address
First Line	:	REPARTO ALHAMBRA D95 AVE. LOS MILLONES
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00959-0000
Country	:	US
Telephone Number	:	787-740-1919
Fax Number	:	787-650-3584

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	10/15/2023

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