Provider Demographics
NPI:1629059936
Name:YORDAN, RAUL A (MD)
Entity Type:Individual
Prefix:DR
First Name:RAUL
Middle Name:A
Last Name:YORDAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 9419
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00988-9419
Mailing Address - Country:US
Mailing Address - Phone:787-750-1670
Mailing Address - Fax:787-752-7860
Practice Address - Street 1:AVE. FRAGOSO ESQ. VIA 59
Practice Address - Street 2:3FS1, VILLA FONTANA
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00983
Practice Address - Country:US
Practice Address - Phone:787-750-1670
Practice Address - Fax:787-752-7860
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2942207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0092461Medicare PIN
PRC77994Medicare UPIN