Basic Information
| Provider Information | |||||||||
| NPI: | 1679526826 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAEZ | ||||||||
| FirstName: | RAFAEL | ||||||||
| MiddleName: | ANGEL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3255 FOREST HILL BLVD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334065854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619644577 | ||||||||
| FaxNumber: | 5612751156 | ||||||||
| Practice Location | |||||||||
| Address1: | 3580 LAKE WORTH ROAD | ||||||||
| Address2: | INTERNAL | ||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 33461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614255075 | ||||||||
| FaxNumber: | 5613603467 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 06/03/2019 | ||||||||
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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 | 207R00000X | ME120375 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.