Basic Information
| Provider Information | |||||||||
| NPI: | 1790757805 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHULZE | ||||||||
| FirstName: | RAFAEL | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3851 ROGER BROOKE DR MCHE-QD (CREDS) | ||||||||
| Address2: | |||||||||
| City: | FORT SAM HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782344501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109162460 | ||||||||
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| Practice Location | |||||||||
| Address1: | 120 INTERNATIONAL PKWY STE 240 | ||||||||
| Address2: | |||||||||
| City: | HEATHROW | ||||||||
| State: | FL | ||||||||
| PostalCode: | 327465033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4073334200 | ||||||||
| FaxNumber: | 4078296637 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2006 | ||||||||
| LastUpdateDate: | 07/01/2019 | ||||||||
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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 | 207ND0101X | A107421 | CA | Y | Allopathic & Osteopathic Physicians | Dermatology | MOHS-Micrographic Surgery |
No ID Information.