MEDICARE: GRP RAFAEL SANCHEZ VALENTIN

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	207RC0000X	Cardiovascular Disease Physician	2117	PR

General Provider Information

NPI Number	:	1447246269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRP RAFAEL SANCHEZ VALENTIN

Provider Business Mailing Address
First Line	:	29 CALLE WASHINGTON
Second Line	:	ASHFORD MEDICAL CENTER STE 308
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1510
Country	:	US
Telephone Number	:	787-725-1603
Fax Number	:	787-721-0439

Provider Business Practice Location Address
First Line	:	29 CALLE WASHINGTON
Second Line	:	ASHFORD MEDICAL CENTER STE 308
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1510
Country	:	US
Telephone Number	:	787-725-1603
Fax Number	:	787-721-0439

Authorized Official
Title or Position	:	SECRETARY
Name	:	MRS. AIDA L SILVA
Credential	:
Telephone Number	:	787-725-1603

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	08/22/2020

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