Basic Information
| Provider Information | |||||||||
| NPI: | 1174889166 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROJANO MARIN | ||||||||
| FirstName: | RAFAEL | ||||||||
| MiddleName: | ANTONIO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ROJANO-MARIN | ||||||||
| OtherFirstName: | RAFAEL | ||||||||
| OtherMiddleName: | ANTONIO | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 8170 33RD AVE S - PO BOX 1309 | ||||||||
| Address2: | MAIL STOP 21110Q | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554254516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7155316700 | ||||||||
| FaxNumber: | 7155316801 | ||||||||
| Practice Location | |||||||||
| Address1: | 405 STAGELINE RD. | ||||||||
| Address2: | |||||||||
| City: | HUDSON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 540167848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7165316700 | ||||||||
| FaxNumber: | 7155316801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2012 | ||||||||
| LastUpdateDate: | 04/07/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 65356-20 | WI | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.