Provider Demographics
NPI:1811207863
Name:ROBERT J DORFF, M.D., P.A.
Entity Type:Organization
Organization Name:ROBERT J DORFF, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DORFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-629-6644
Mailing Address - Street 1:1925 MIZELL AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4106
Mailing Address - Country:US
Mailing Address - Phone:407-629-6644
Mailing Address - Fax:407-629-2045
Practice Address - Street 1:1925 MIZELL AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4106
Practice Address - Country:US
Practice Address - Phone:407-629-6644
Practice Address - Fax:407-629-2045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 38152207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL47405Medicare PIN