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NPI Code Detail

MEDICARE: FARMACIA SAN RAFAEL SANTURCE, INC

MEDICARE: FARMACIA SAN RAFAEL SANTURCE, INC
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
13336C0003XCommunity/Retail Pharmacy17-F-2298PR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
117-F-2298OTHERPRSTATE LICENSE

General Provider Information

NPI Number : 1952446825
Entity Type Code : Organization
Provider Name (Legal Business Name) : FARMACIA SAN RAFAEL SANTURCE, INC
Provider Business Mailing Address
First Line : 851 CALLE LAFAYETTE
Second Line : PDA 20
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 : PDA 20
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 : ADMINISTRATOR
Name : MR. RAFAEL ANGEL DIAZ REYES
Credential : PH T.
Telephone Number : 787-724-3333
Provider Enumeration Date : 02/20/2007
Last Update Date : 03/07/2023

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1851835615 — RAFAEL DIAZ REYES PH.T.
Practice Location Address:
851 CALLE LAFAYETTE , URB. HIPODROMO
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Practice Phone: 787-724-3333
Practice Fax: 787-721-4165

Directions to “FARMACIA SAN RAFAEL SANTURCE, INC ” Practice Location

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