Organization
MARK JAFFE M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JAFFE M.D. (PRESIDENT)
(954) 441-9995
Entity
Organization
Contact information
Practice address
1 SW 129TH AVE, PEMBROKE PINES, FL 33027-1761
(954) 441-9995
(954) 441-9033
Mailing address
1 SW 129TH AVE, PEMBROKE PINES, FL 33027-1761
(954) 441-9995
(954) 441-9033
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME0068879
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
379137800
—
FL
01
—
FR664A
MEDICARE PTAN
FL
Enumeration date
08/03/2006
Last updated
03/12/2012
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