Provider Demographics
NPI:1205658234
Name:CARVALHO, RAFAEL EDIPO (NREMT-P)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:EDIPO
Last Name:CARVALHO
Suffix:
Gender:M
Credentials:NREMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 WIANNO AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:OSTERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02655-2009
Mailing Address - Country:US
Mailing Address - Phone:508-815-9434
Mailing Address - Fax:
Practice Address - Street 1:32 WIANNO AVE STE 5
Practice Address - Street 2:
Practice Address - City:OSTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02655-2009
Practice Address - Country:US
Practice Address - Phone:508-441-4941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0901902146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic