Provider Demographics
NPI:1578506234
Name:VASQUEZ PELYHE, RAFAEL ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:ANTONIO
Last Name:VASQUEZ PELYHE
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:TORRE MEDICA SAN CRISTOBAL, SUITE 401
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780
Mailing Address - Country:US
Mailing Address - Phone:787-842-9100
Mailing Address - Fax:787-844-4858
Practice Address - Street 1:TORRE MEDICA SAN CRISTOBAL, SUITE 401
Practice Address - Street 2:
Practice Address - City:COTO LAUREL
Practice Address - State:PR
Practice Address - Zip Code:00780
Practice Address - Country:US
Practice Address - Phone:787-842-9100
Practice Address - Fax:787-844-4858
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14206207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022035Medicare PIN
H96282Medicare UPIN
PRH96282Medicare UPIN