Organization
RAFAEL J NOBO JR M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFAEL J NOBO JR. M.D., P.A. (OWNER/PHYSICIAN)
(863) 533-8944
Entity
Organization
Contact information
Practice address
222 W MAIN ST, SUITE B, BARTOW, FL 33830-4531
(863) 533-8944
(863) 533-1577
Mailing address
222 W MAIN ST, SUITE B, BARTOW, FL 33830-4531
(863) 533-8944
(863) 533-1577
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME41315
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
53722
MEDICARE
FL
Enumeration date
12/08/2011
Last updated
12/15/2011
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