1609800143 NPI number — DR. RAFAEL FELIZ LEBREAULT M.D.

Table of content: DR. RAFAEL FELIZ LEBREAULT M.D. (NPI 1609800143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609800143 NPI number — DR. RAFAEL FELIZ LEBREAULT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELIZ LEBREAULT
Provider First Name:
RAFAEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1609800143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4615
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VEGA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00694-4615
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-855-1385
Provider Business Mailing Address Fax Number:
787-807-8912

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR. NUM. 2 KM 39.5
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
VEGA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-855-1385
Provider Business Practice Location Address Fax Number:
787-807-8912
Provider Enumeration Date:
07/10/2006

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: 207R00000X , with the licence number:  4823 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 100197 . This is a "MEDICARE MUCHO MAS ID#" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 212176 . This is a "UTI" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 25874 . This is a "SSS OF PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 25874 . This is a "MEDICARE OPTIMO ID#" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4823 . This is a "COSVI PROVIDER ID" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 1661 . This is a "PEFERRED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4823 . This is a "IMC PROVIDER ID" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6430019 . This is a "HUMANA PORVIDER ID" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 063664 . This is a "CRUZ AZUL DE PUERTO RICO" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 29825 . This is a "AAMPR PROVIDER ID" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 3387 . This is a "AMERICAN HEALTH PLAN" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 4304823 . This is a "UIA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com