Individual
GORDON J RAFOOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
635 1ST ST N, WINTER HAVEN, FL 33881-4129
(863) 294-0670
(863) 298-3200
Mailing address
635 1ST ST N, WINTER HAVEN, FL 33881-4129
(863) 294-0670
(863) 298-3200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME18395
FL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
ME18395
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010011714
MEDICARE ID/ RRM PIN
FL
05
—
062153600
—
FL
Enumeration date
03/16/2006
Last updated
05/20/2008
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