MEDICARE: RAFAEL FEDERICO MARTIN GARCIA MD

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	207N00000X	Dermatology Physician	10,707	PR

General Provider Information

NPI Number	:	1942299375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFAEL FEDERICO MARTIN GARCIA MD

Provider Business Mailing Address
First Line	:	1451 AVE ASHFORD
Second Line	:	SUITE 611
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1511
Country	:	US
Telephone Number	:	787-724-3407
Fax Number	:	787-977-7876

Provider Business Practice Location Address
First Line	:	1451 AVE ASHFORD
Second Line	:	SUITE 611
City	:	SAN JUAN
State	:	PR
Zip	:	00907-1511
Country	:	US
Telephone Number	:	787-724-3407
Fax Number	:	787-977-7876

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	11/21/2013

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