Provider Demographics
NPI:1548298201
Name:RAFANAN, DEBBIE M (PA-C)
Entity type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:M
Last Name:RAFANAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:M
Other - Last Name:RAFANAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-273-7374
Mailing Address - Fax:352-273-7388
Practice Address - Street 1:1600 SW ARCHER ROAD
Practice Address - Street 2:BOX 100371
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0371
Practice Address - Country:US
Practice Address - Phone:352-273-7374
Practice Address - Fax:352-273-7388
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA1928363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S50469Medicare UPIN
FLE0285Medicare ID - Type Unspecified