Provider Demographics
NPI:1316938194
Name:ALBANDOZ, RAFAEL JOSE JR (MD)
Entity type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:JOSE
Last Name:ALBANDOZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:26 CALLE 1
Mailing Address - Street 2:VILLA LOS OLMOS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927-4605
Mailing Address - Country:US
Mailing Address - Phone:787-764-6267
Mailing Address - Fax:787-764-6267
Practice Address - Street 1:110 CALLE GEORGETTI
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00925-3505
Practice Address - Country:US
Practice Address - Phone:787-764-1830
Practice Address - Fax:787-767-7741
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6414207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
068094OtherCRUZ AXUL
2849OtherAMERICAN HEALTH
26414OtherCIGNA
2992OtherIMC
PC0542OtherPALIC
2 7818OtherSSS
26414OtherMCS
9280027OtherHUMANA
3706414OtherUIA
209071OtherUTI
26414OtherCIGNA
2992OtherIMC