Provider Demographics
NPI:1154330173
Name:NADAL-ARRILLAGA, RAFAEL ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ANTONIO
Last Name:NADAL-ARRILLAGA
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:#55 MEDITACION ST
Mailing Address - Street 2:SUITE 7A
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-4855
Mailing Address - Country:US
Mailing Address - Phone:787-833-3345
Mailing Address - Fax:787-833-3345
Practice Address - Street 1:#55 MEDITACION ST
Practice Address - Street 2:SUITE 7A
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-4855
Practice Address - Country:US
Practice Address - Phone:787-833-3345
Practice Address - Fax:787-833-3345
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3240207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR3240OtherLIC
C77216Medicare UPIN
NA94206Medicare ID - Type Unspecified