Provider Demographics
NPI:1477580157
Name:GARFINKEL, BOBBY C (DMD)
Entity Type:Individual
Prefix:
First Name:BOBBY
Middle Name:C
Last Name:GARFINKEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1573 W FAIRBANKS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4679
Mailing Address - Country:US
Mailing Address - Phone:407-644-0224
Mailing Address - Fax:
Practice Address - Street 1:1573 W FAIRBANKS AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4679
Practice Address - Country:US
Practice Address - Phone:407-644-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN119811223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26336OtherWELLCARE WP
FL224947OtherWELLCARE-LW
FL224949OtherWELLCARE-ORL
FL4337868OtherAETNA PPO
FL632700OtherAETNA HMO
FL075103100Medicaid
FL69391OtherBCBS
FL4337868OtherAETNA PPO
FL69391XMedicare ID - Type UnspecifiedWINTER PARK
FL26336OtherWELLCARE WP
FL224949OtherWELLCARE-ORL