Provider Demographics
NPI:1629248539
Name:VALDESPINO, RAFAEL HECTOR (MD)
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:HECTOR
Last Name:VALDESPINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAFAEL
Other - Middle Name:HECTOR
Other - Last Name:VALDESPINO PAIROL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:777 E 25TH ST STE 419
Mailing Address - Street 2:HIALEAH
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3835
Mailing Address - Country:US
Mailing Address - Phone:305-667-9519
Mailing Address - Fax:786-375-5397
Practice Address - Street 1:777 E 25TH ST STE 419
Practice Address - Street 2:HIALEAH
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3835
Practice Address - Country:US
Practice Address - Phone:305-667-9519
Practice Address - Fax:786-375-5397
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR26460207R00000X
FLME 104195207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine