Individual
LARRY DEAN RAFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4415 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-6307
(850) 951-4556
(850) 951-4527
Mailing address
4415 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-6307
(850) 951-4556
(850) 951-4527
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3233
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
290274500
—
FL
Enumeration date
06/22/2006
Last updated
06/23/2010
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