Raul San Juan
Internal Medicine in Fort Lauderdale, FL. Individual provider (NPI-1).
NPI number1124489331
StatusActive
Last updated in NPPESSep 12, 2023
Details
- NPI
- 1124489331
- Entity type
- Individual (NPI-1)
- Name
- Raul San Juan
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 15, 2016
- Certification date
- Sep 12, 2023
- Last updated
- Sep 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | OS16495 | FL | Yes |
Practice location
4800 N Federal Hwy Ste 200Fort Lauderdale, FL 33308-4611
Phone 954-771-2111 · Fax 954-983-1152
Mailing address
4800 N Federal Hwy Ste 200Fort Lauderdale, FL 33308-4611
Phone 954-771-2111 · Fax 954-983-1152
Other practice locations
4613 S Orange Blossom Trl
Orlando, FL 32839-1705
Orlando, FL 32839-1705
Phone 407-232-9833 · Fax 407-232-9829
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