Provider Demographics
NPI:1962616839
Name:CUEBAS-FERNANDEZ, RAFAEL RAYMUNDO
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:RAYMUNDO
Last Name:CUEBAS-FERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB JACARANDA
Mailing Address - Street 2:CALLE B, #D-5
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00731
Mailing Address - Country:US
Mailing Address - Phone:787-376-0655
Mailing Address - Fax:
Practice Address - Street 1:URB JACARANDA
Practice Address - Street 2:CALLE B, #D-5
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00731
Practice Address - Country:US
Practice Address - Phone:787-376-0655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR59662083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine