Individual
RAFAEL EDUARDO PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1331 S INTERNATIONAL PKWY STE 1261, LAKE MARY, FL 32746-1405
(407) 444-4848
(407) 444-4870
Mailing address
5224 SR 46 # 376, SANFORD, FL 32771-9230
(407) 444-4848
(407) 444-4870
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
ME137799
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JL066Z
MEDICARE
—
Enumeration date
06/23/2006
Last updated
11/28/2022
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