Provider Demographics
NPI:1932357092
Name:TRINIDAD HERNANDEZ, RAFAEL (M D)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:TRINIDAD HERNANDEZ
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 79284
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00984-9284
Mailing Address - Country:US
Mailing Address - Phone:787-729-7777
Mailing Address - Fax:787-620-0045
Practice Address - Street 1:SAN JORGE MEDICAL BUILDING
Practice Address - Street 2:252 CALLE SAN JORGE STE 301
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912-3239
Practice Address - Country:US
Practice Address - Phone:787-729-7777
Practice Address - Fax:787-620-0045
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17930207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR17930OtherINTERNAL MEDICINE- ENDOCRINOLOGY