1104137884 NPI number — DR. RAFAEL LAPPOST DPM

Table of content: DR. RAFAEL LAPPOST DPM (NPI 1104137884)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104137884 NPI number — DR. RAFAEL LAPPOST DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAPPOST
Provider First Name:
RAFAEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104137884
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 160790
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIALEAH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33016-0014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-774-0413
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6175 NW 153RD ST STE 212
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIAMI LAKES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-989-4702
Provider Business Practice Location Address Fax Number:
305-735-6720
Provider Enumeration Date:
06/28/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  PO3514 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)