Provider Demographics
NPI:1902046659
Name:RIQUELME-ABRAMS, RAFAEL ANGEL (PSYD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:ANGEL
Last Name:RIQUELME-ABRAMS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 927
Mailing Address - Street 2:CARR #2 KM 112.6
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-0927
Mailing Address - Country:US
Mailing Address - Phone:787-399-4955
Mailing Address - Fax:787-830-4060
Practice Address - Street 1:2993 AVE MILITAR
Practice Address - Street 2:CARR #2 KM 112.6
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-4078
Practice Address - Country:US
Practice Address - Phone:787-399-4955
Practice Address - Fax:787-830-4060
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-20
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3291103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical