Provider Demographics
NPI:1376653162
Name:BURGOS-CALDERON, RAFAEL ANTONIO (MD)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ANTONIO
Last Name:BURGOS-CALDERON
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:NEFROLOGIA 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:
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:00922-2116
Practice Address - Country:US
Practice Address - Phone:787-758-7910
Practice Address - Fax:787-294-3609
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3098207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology