Individual
RAFAEL PASTRANA LABORDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
735 AVE PONCE DE LEON, STE 816, HATO REY, PR 00917-5022
(787) 505-5482
(787) 250-1928
Mailing address
735 AVE PONCE DE LEON STE 816, TORRE MEDICA AUXILIO MUTUO, SAN JUAN, PR 00917
(787) 763-1025
(787) 250-1928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME96195
FL
207RG0100X
Gastroenterology Physician
Primary
ME96195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275571800
—
FL
01
—
53390
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/07/2006
Last updated
07/17/2013
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