Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 11589 | PR |
NPI | 1023166055 |
---|---|
Provider Name | Dr. Rafael H Zaragoza Urdaz |
First Address | San Juan, PR 00918-3511 |
Second Address | San Juan, PR 00918-3511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 01/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
84639 | MEDICARE PROVIDER NUMBER (01) | PR |
F27119 | (02) |