Provider Demographics
NPI:1629086335
Name:URBINO, RAFAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:URBINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 PRESIDENTIAL WAY APT 201A
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1844
Mailing Address - Country:US
Mailing Address - Phone:561-459-7292
Mailing Address - Fax:561-588-7316
Practice Address - Street 1:6000 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33405-4028
Practice Address - Country:US
Practice Address - Phone:561-582-7660
Practice Address - Fax:561-588-7316
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist