Provider Demographics
NPI:1851673677
Name:SERVICIOS MEDICOS PRIMARIOS DR RAFAEL ALVAREZ,CSP
Entity Type:Organization
Organization Name:SERVICIOS MEDICOS PRIMARIOS DR RAFAEL ALVAREZ,CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-834-2068
Mailing Address - Street 1:PO BOX 2955
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-2955
Mailing Address - Country:US
Mailing Address - Phone:787-834-2068
Mailing Address - Fax:787-834-3625
Practice Address - Street 1:114 CANDELARIA ST
Practice Address - Street 2:SUITE 206
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-834-2068
Practice Address - Fax:787-834-3625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-19
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6592261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE31502Medicare UPIN