Provider Demographics
NPI:1407803067
Name:SAN RAFAEL CARE, INC.
Entity type:Organization
Organization Name:SAN RAFAEL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:BATISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-265-7944
Mailing Address - Street 1:7805 SW 24TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-6539
Mailing Address - Country:US
Mailing Address - Phone:305-265-7944
Mailing Address - Fax:305-265-7943
Practice Address - Street 1:7805 SW 24TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6539
Practice Address - Country:US
Practice Address - Phone:305-265-7944
Practice Address - Fax:305-265-7943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL7879332B00000X, 332BP3500X
FL32:01006332BX2000X
335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1022970001Medicare ID - Type Unspecified