Provider Demographics
NPI:1649221607
Name:MACHIN, RAFAEL A
Entity Type:Individual
Prefix:
First Name:RAFAEL
Middle Name:A
Last Name:MACHIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. PASEO LOS ROBLES
Mailing Address - Street 2:1322 CALLE DR. RAMIREZ QUILES
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-638-1948
Mailing Address - Fax:787-589-7178
Practice Address - Street 1:93 CALLE COLON
Practice Address - Street 2:
Practice Address - City:AGUADA
Practice Address - State:PR
Practice Address - Zip Code:00602-3054
Practice Address - Country:US
Practice Address - Phone:787-252-2165
Practice Address - Fax:787-868-7258
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15552208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
22986Medicare ID - Type Unspecified
I27846Medicare UPIN