Provider Demographics
NPI:1043876543
Name:RAFAEL A. MACHIN PORRATA, LLC
Entity Type:Organization
Organization Name:RAFAEL A. MACHIN PORRATA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:MACHIN PORRATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-589-7178
Mailing Address - Street 1:PASEO LOS ROBLES
Mailing Address - Street 2:1322 CALLE DR RAMIREZ QUILES
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-589-7178
Mailing Address - Fax:787-589-7185
Practice Address - Street 1:93 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3054
Practice Address - Country:US
Practice Address - Phone:787-589-7178
Practice Address - Fax:787-589-7185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-10
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service