Provider Demographics
NPI:1750618674
Name:ROURE, RAFAEL ANGEL (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:ANGEL
Last Name:ROURE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 GLEN BURNIE CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-6580
Mailing Address - Country:US
Mailing Address - Phone:757-430-1900
Mailing Address - Fax:
Practice Address - Street 1:1304 GLEN BURNIE CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-6580
Practice Address - Country:US
Practice Address - Phone:757-430-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-13
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043292207QA0505X
IA17826207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine