Provider Demographics
NPI:1740482520
Name:ROSA-ALGARIN, RAFAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:A
Last Name:ROSA-ALGARIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAFAEL
Other - Middle Name:ANGEL
Other - Last Name:ROSA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1750 SE 28TH LOOP
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-1080
Mailing Address - Country:US
Mailing Address - Phone:352-351-4634
Mailing Address - Fax:352-351-1900
Practice Address - Street 1:1750 SE 28TH LOOP
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-1080
Practice Address - Country:US
Practice Address - Phone:352-351-4634
Practice Address - Fax:352-351-1900
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN220208D00000X
PR13858282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20772Medicare ID - Type Unspecified
PRH55192Medicare UPIN