Provider Demographics
NPI:1144427758
Name:GONZALEZ-ROSARIO, RAFAEL A (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:A
Last Name:GONZALEZ-ROSARIO
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:DEPARTAMENTO DE MEDICINA INTERNA RCM
Mailing Address - Street 2:PO BOX 29134
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-0134
Mailing Address - Country:US
Mailing Address - Phone:787-751-6034
Mailing Address - Fax:787-754-1739
Practice Address - Street 1:CLINICA DE LA ESCUELA DE MEDICINA
Practice Address - Street 2:REPARTO METROPOLITANO SHOPPING, AVE. AMERICO MIRANDA
Practice Address - City:RIO PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00921-8304
Practice Address - Country:US
Practice Address - Phone:787-758-7910
Practice Address - Fax:787-625-1966
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR17069207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0028532Medicare PIN