Provider Demographics
NPI:1881712925
Name:GARCIA, RAFAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST.6-URB. VILLA OLIMPIA
Mailing Address - Street 2:C-17
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-4305
Mailing Address - Country:US
Mailing Address - Phone:787-856-2080
Mailing Address - Fax:787-856-2080
Practice Address - Street 1:URB. VILLA OLIMPIA CALLE 6
Practice Address - Street 2:C-17
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698-4305
Practice Address - Country:US
Practice Address - Phone:787-856-2080
Practice Address - Fax:787-856-2080
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5176207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC77413Medicare UPIN
PR2-6394Medicare ID - Type Unspecified