Provider Demographics
NPI:1821030925
Name:ARONOFF, DAVID R (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:ARONOFF
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 1:2900 S HIGHWAY 77
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-5612
Mailing Address - Country:US
Mailing Address - Phone:850-818-0021
Mailing Address - Fax:
Practice Address - Street 1:740 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-2524
Practice Address - Country:US
Practice Address - Phone:850-818-0021
Practice Address - Fax:850-818-0024
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01069264A208800000X
KY44488208800000X
TXL2792208800000X
TN533912088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ017710Medicaid
TX107706104OtherFIRSTCARE
IN200226610Medicaid
TX8X8750OtherBCBS IND
KY7100166940Medicaid
TX8F5659Medicare PIN
KY7100166940Medicaid
TN103I348773Medicare PIN
TX8X8750OtherBCBS IND
TX107706104OtherFIRSTCARE