Provider Demographics
NPI:1568774909
Name:BOBRUFF, JEROME (MD)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:
Last Name:BOBRUFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2171 PINE RIDGE RD STE F
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2002
Mailing Address - Country:US
Mailing Address - Phone:239-566-6425
Mailing Address - Fax:239-593-3430
Practice Address - Street 1:2171 PINE RIDGE RD STE F
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2002
Practice Address - Country:US
Practice Address - Phone:239-566-6425
Practice Address - Fax:239-593-3430
Is Sole Proprietor?:No
Enumeration Date:2010-07-13
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLACN348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDM316ZMedicare Oscar/Certification