Provider Demographics
NPI:1881344695
Name:CUMMINGS LOPEZ, RAFAEL JOSE
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:JOSE
Last Name:CUMMINGS LOPEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB VALLE ARRIBA
Mailing Address - Street 2:137 CALLE ROBLE
Mailing Address - City:COAMO
Mailing Address - State:PR
Mailing Address - Zip Code:00769
Mailing Address - Country:US
Mailing Address - Phone:787-325-6768
Mailing Address - Fax:
Practice Address - Street 1:URB VALLE ARRIBA
Practice Address - Street 2:137 CALLE ROBLE
Practice Address - City:COAMO
Practice Address - State:PR
Practice Address - Zip Code:00769
Practice Address - Country:US
Practice Address - Phone:787-325-6768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program