Provider Demographics
NPI:1447344114
Name:OLIVERAS-RENTAS, RAFAEL EFRAIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:EFRAIN
Last Name:OLIVERAS-RENTAS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2431 AVE. LAS AMERICAS EDIF. A. PORRATA PILA
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-2114
Mailing Address - Country:US
Mailing Address - Phone:787-848-5050
Mailing Address - Fax:
Practice Address - Street 1:2431 AVE. LAS AMERICAS EDIF. A. PORRATA PILA
Practice Address - Street 2:SUITE 205
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2114
Practice Address - Country:US
Practice Address - Phone:787-848-5050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2677103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical