Provider Demographics
NPI:1194016378
Name:JUNCO, RAFAEL (MD)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:JUNCO
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 1:2750 W 68TH ST STE 127-128
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5446
Mailing Address - Country:US
Mailing Address - Phone:305-558-0765
Mailing Address - Fax:305-558-0768
Practice Address - Street 1:2750 W 68TH ST STE 127-128
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-5446
Practice Address - Country:US
Practice Address - Phone:305-633-3776
Practice Address - Fax:305-633-4240
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-22
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME120311207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine