MEDICARE: DR. RAUL HOLGUIN M.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	207Q00000X	Family Medicine Physician	ME55506	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0098908001	OTHER	FL	CIGNA
2	41593	OTHER	FL	BC/BS GROUP #
3	1360442	OTHER	FL	UNITED HEALTH CARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295733178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAUL HOLGUIN M.D.

Provider Business Mailing Address
First Line	:	1211 JACARANDA BLVD
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-4520
Country	:	US
Telephone Number	:	914-492-2212
Fax Number	:	941-496-9307

Provider Business Practice Location Address
First Line	:	1211 JACARANDA BLVD
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34292-4520
Country	:	US
Telephone Number	:	914-492-2212
Fax Number	:	941-496-9307

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	07/09/2007

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