Provider Demographics
NPI:1821152547
Name:RAIFFE, LANCE P (MD)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:P
Last Name:RAIFFE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4302 ALTON RD
Mailing Address - Street 2:SUITE 620
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140
Mailing Address - Country:US
Mailing Address - Phone:305-538-8658
Mailing Address - Fax:305-531-5827
Practice Address - Street 1:4302 ALTON RD
Practice Address - Street 2:SUITE 620
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140
Practice Address - Country:US
Practice Address - Phone:305-538-8658
Practice Address - Fax:305-531-5827
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL478102086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
07239Medicare PIN
D21182Medicare UPIN