Provider Demographics
NPI:1841230562
Name:DELGADO, RAFAEL ANIBAL SR (GP MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:ANIBAL
Last Name:DELGADO
Suffix:SR
Gender:M
Credentials:GP MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:YABUCOA
Mailing Address - State:PR
Mailing Address - Zip Code:00767-0194
Mailing Address - Country:US
Mailing Address - Phone:787-893-5432
Mailing Address - Fax:787-465-2353
Practice Address - Street 1:22 CALLE CRISTOBAL COLON
Practice Address - Street 2:
Practice Address - City:YABUCOA
Practice Address - State:PR
Practice Address - Zip Code:00767-3326
Practice Address - Country:US
Practice Address - Phone:787-893-5432
Practice Address - Fax:787-465-2353
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR10149208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0082691Medicare ID - Type Unspecified
PRF288867Medicare UPIN