Rafool, Gordon J

Rafool, Gordon J is an sole proprietor health care provider with primary practice located at 635 1St St N , Winter Haven FL 33881-4129. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is his primary health care specialty. Rafool, Gordon J can be contacted via phone (863) 294-0670.

Contact Information

Primary practice address
635 1St St N Winter Haven FL 33881-4129
Phone: (863) 294-0670
Fax: (863) 298-3200
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME18395 Florida
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X ME18395 Florida

Profile Details

NPI number 1407825821
LBN Legal business name Rafool, Gordon J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 16th, 2006
Last updated May 20th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407825821 NPPES
Florida MEDICAID 062153600
Florida Other 010011714

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