Provider Demographics
NPI:1801784335
Name:SIACA MEZA, RAFAEL JOSE (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:JOSE
Last Name:SIACA MEZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 CALLE COLIBRI
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727-1272
Mailing Address - Country:US
Mailing Address - Phone:787-955-3706
Mailing Address - Fax:
Practice Address - Street 1:96 CALLE COLIBRI
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-1272
Practice Address - Country:US
Practice Address - Phone:787-955-3706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6522964207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine