Provider Demographics
NPI:1720055684
Name:AQUINO-HERNANDEZ, RAFAEL A (MD)
Entity type:Individual
Prefix:DR
First Name:RAFAEL
Middle Name:A
Last Name:AQUINO-HERNANDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAFAEL
Other - Middle Name:A
Other - Last Name:AQUINO-HERNANDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:36 CALLE 65 INFANTERIA
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610-2902
Mailing Address - Country:US
Mailing Address - Phone:787-934-8737
Mailing Address - Fax:787-826-5251
Practice Address - Street 1:36 CALLE 65 INFANTERIA
Practice Address - Street 2:
Practice Address - City:ANASCO
Practice Address - State:PR
Practice Address - Zip Code:00610-2902
Practice Address - Country:US
Practice Address - Phone:787-934-8737
Practice Address - Fax:787-826-5251
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-28
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR014980208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR21945Medicare ID - Type Unspecified
PRH96914Medicare UPIN