Provider Demographics
NPI:1841393170
Name:CAMPOS, RAFAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:S
Last Name:CAMPOS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:439 CALLE REY LUIS
Mailing Address - Street 2:LA VILLA DE TORRIMAR
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00969-3170
Mailing Address - Country:US
Mailing Address - Phone:787-740-3955
Mailing Address - Fax:787-778-1144
Practice Address - Street 1:SANTA CRUZ ST., EDIF. ARTURO CADILLA
Practice Address - Street 2:SUITE 407
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-740-9355
Practice Address - Fax:787-778-1144
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PR7304207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC78241Medicare UPIN