MEDICARE: DR. RAFAEL F RIVAS-CHACON 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	207RR0500X	Rheumatology Physician	ME0048624	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306875075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAFAEL F RIVAS-CHACON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 431169
Second Line	:
City	:	SOUTH MIAMI
State	:	FL
Zip	:	33243-1169
Country	:	US
Telephone Number	:	305-663-8585
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 SW 60TH CT STE 105
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33155-4069
Country	:	US
Telephone Number	:	305-663-8505
Fax Number	:	305-663-6878

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

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	03/29/2021

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Directions to “ DR. RAFAEL F RIVAS-CHACON M.D.” Practice Location

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