Provider Demographics
NPI:1720542921
Name:MASSA TORMOS, RAFAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:
Last Name:MASSA TORMOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-6773
Mailing Address - Country:US
Mailing Address - Phone:407-744-7539
Mailing Address - Fax:
Practice Address - Street 1:4028 13TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-6773
Practice Address - Country:US
Practice Address - Phone:407-744-7539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-22
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12618111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor