Provider Demographics
NPI:1043247893
Name:MATOS, RAFAEL (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:MATOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 937
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-0937
Mailing Address - Country:US
Mailing Address - Phone:787-834-2130
Mailing Address - Fax:787-834-2010
Practice Address - Street 1:59B CALLE MEDITACION
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4818
Practice Address - Country:US
Practice Address - Phone:787-834-2130
Practice Address - Fax:787-834-2010
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2017-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10360207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR11324-04004780OtherUNITED HEALTH CARE
PRPE3595OtherPANAMERICAN
PR116-10360OtherPLAN GLOBAL
PR212071OtherUTI
PR00638OtherCRUZ AZUL
PR58392926OtherSALUD BELLA VISTA
PR6800131OtherHUMANA INSURANCE
PR88848MAOtherTRIPLE-S
PR3732726OtherFAMILY CARE
PR6800131OtherHUMANA INSURANCE