Provider Demographics
NPI:1023025855
Name:RAFI, MOHAMMED H (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:H
Last Name:RAFI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5142 WILD ROSE WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-7551
Mailing Address - Country:US
Mailing Address - Phone:850-894-1078
Mailing Address - Fax:
Practice Address - Street 1:333 N BYRON BUTLER PKWY
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32347-2300
Practice Address - Country:US
Practice Address - Phone:850-584-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72364207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL32698OtherBLUECROSS
FL32698AMedicare ID - Type Unspecified
FL32698OtherBLUECROSS