Provider Demographics
NPI:1609807452
Name:RAFF, IRA L (MD)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:L
Last Name:RAFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5258 LINTON BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6540
Mailing Address - Country:US
Mailing Address - Phone:561-495-7570
Mailing Address - Fax:561-496-7074
Practice Address - Street 1:5258 LINTON BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6540
Practice Address - Country:US
Practice Address - Phone:561-495-7570
Practice Address - Fax:561-496-7074
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL18707208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27973OtherBLUE CROSS BLUE SHIELD
FL27973OtherBLUE CROSS BLUE SHIELD