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NPI Code Detail

MEDICARE: RAFAEL DIAZ REYES PH.T.

MEDICARE: RAFAEL DIAZ REYES PH.T.
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
1183700000XPharmacy Technician2542PR

General Provider Information

NPI Number : 1851835615
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAFAEL DIAZ REYES PH.T.
Provider Business Mailing Address
First Line : 851 CALLE LAFAYETTE
Second Line : URB. HIPODROMO
City : SAN JUAN
State : PR
Zip : 00909-2627
Country : US
Telephone Number : 787-724-3333
Fax Number : 787-721-4165
Provider Business Practice Location Address
First Line : 851 CALLE LAFAYETTE
Second Line : URB. HIPODROMO
City : SAN JUAN
State : PR
Zip : 00909-2627
Country : US
Telephone Number : 787-724-3333
Fax Number : 787-721-4165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2016
Last Update Date : 12/14/2016

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