Provider Demographics
NPI:1487751012
Name:CHIONG, RAFAEL (MD)
Entity type:Individual
Prefix:
First Name:RAFAEL
Middle Name:
Last Name:CHIONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 442217
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-9217
Mailing Address - Country:US
Mailing Address - Phone:305-223-2930
Mailing Address - Fax:305-223-3242
Practice Address - Street 1:14740 SW 26TH ST
Practice Address - Street 2:STE 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5948
Practice Address - Country:US
Practice Address - Phone:305-388-1118
Practice Address - Fax:305-223-3242
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 95088207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAH128ZMedicare PIN
FL276707400Medicaid