Provider Demographics
NPI:1477806438
Name:RAFALKO, JOHN W (EDD, PA-C)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:RAFALKO
Suffix:
Gender:M
Credentials:EDD, PA-C
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Mailing Address - Street 1:DR. JOHN W. RAFALKO, 3200 SOUTH UNIVERSITY DR.
Mailing Address - Street 2:NSU, HPD, CHCS, PA DEPARTMENT, ROOM 1287
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2018
Mailing Address - Country:US
Mailing Address - Phone:954-262-1287
Mailing Address - Fax:954-262-2285
Practice Address - Street 1:DR. JOHN W. RAFALKO, 3200 SOUTH UNIVERSITY DR.
Practice Address - Street 2:NSU, HPD, CHCS, PA DEPARTMENT, ROOM 1287
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-1287
Practice Address - Fax:954-262-2285
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
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Provider Licenses
StateLicense IDTaxonomies
NY7937253363A00000X
MDC0001101363A00000X
GA1016380 PA-C NCCPA#363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant