Doctor Name: | DR. RAFAEL ANGEL ORTIZ GRAULAU |
NPI Number: | 1700883931 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 11212 |
Business Practice Address: | 8900 Se 165th Mulberry Ln The Villages, FL - 321625884 |
Business Phone Number: | 3526745000 |
Business Fax Number: | 3526745030 |
Mailing Address: | 8900 Se 165th Mulberry Ln, THE VILLAGES |
State: | FL |
Postal Code: | 321625884 |
Phone Number: | 3526745000 |
Fax Number: | 3526745030 |
NPI Enumeration Date: | 07/01/2005 |
NPI Last Update Date: | 10/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 11212 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PR |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |