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Contact Information

RAFAEL S BRICENO, MD
3363 SHERIDAN ST
SUITE 207
HOLLYWOOD, FL33021-3664
 Phone: 954-964-2450
 Fax: 954-964-6084
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for RAFAEL S BRICENO · (Male)

NPI Number 1174670863
Status Active
Credentials MD
Entity Individual
Enumeration date 01/04/2007
Last updated 07/08/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • AL License # MD29002
  • CA License # A97677
  • FL License # ME97155
  • FL Medicaid 003117000
  • FL Other 14P2T FLORIDA BLUE
Hospital affiliation(s)
  • MEMORIAL HOSPITAL WEST - (Acute Care)
    703 N FLAMINGO RD
    PEMBROKE PINES, FL 33028
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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