Provider Demographics
NPI:1346517059
Name:ROUFFE, JONATHAN
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:ROUFFE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 PARK PLACE CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1464
Mailing Address - Country:US
Mailing Address - Phone:561-674-2766
Mailing Address - Fax:561-674-2766
Practice Address - Street 1:5315 PARK PLACE CIR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1464
Practice Address - Country:US
Practice Address - Phone:561-674-2766
Practice Address - Fax:561-674-2766
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH10479111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor