MEDICARE: MR. RAFAEL JORGE MENENDEZ RRT

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	227900000X	Registered Respiratory Therapist	RT5541	FL

General Provider Information

NPI Number	:	1467594523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RAFAEL JORGE MENENDEZ RRT

Provider Business Mailing Address
First Line	:	1352 S. W. 75 AVENUE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2244
Country	:	US
Telephone Number	:	305-266-4474
Fax Number	:

Provider Business Practice Location Address
First Line	:	4284 S. W. 161 PLACE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33185
Country	:	US
Telephone Number	:	786-208-2813
Fax Number	:

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

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	07/09/2007

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