Provider Demographics
NPI:1336105428
Name:FERNANDEZ-SOLTERO, RAFAEL MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:MANUEL
Last Name:FERNANDEZ-SOLTERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAFAEL
Other - Middle Name:MANUEL
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 800809
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-0809
Mailing Address - Country:US
Mailing Address - Phone:787-843-3971
Mailing Address - Fax:787-842-5841
Practice Address - Street 1:TORRE SAN CRISTOBAL
Practice Address - Street 2:SUITE 201
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-843-3971
Practice Address - Fax:787-842-5841
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1881207X00000X
WI1881-320207X00000X
PR11339207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0083714Medicare PIN
PRE68039Medicare UPIN