Provider Demographics
NPI:1962860312
Name:FIGUEROA, ERNESTO RAFAEL (SURGICAL ASSISTANT)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:RAFAEL
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:SURGICAL ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8280 NW 28TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3185
Mailing Address - Country:US
Mailing Address - Phone:954-670-6381
Mailing Address - Fax:
Practice Address - Street 1:8280 NW 28TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3185
Practice Address - Country:US
Practice Address - Phone:954-670-6381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-31
Last Update Date:2016-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16-105OtherAMERICAN BOARD OF SURGICAL ASSISTANTS