Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 1146 | PR |
Y | 213EG0000X | General Practice | 1146 | PR |
NPI | 1003901091 |
---|---|
Provider Name | Dr. Rafael A Joglar |
First Address | Manati, PR 00674-3134 |
Second Address | Manati, PR 00674-5012 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |