Provider Demographics
NPI:1831116359
Name:DORFF, ROBERT JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:DORFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 MIZELL AVE
Mailing Address - Street 2:#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:#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
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38152207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL47405Medicare ID - Type Unspecified
FLA83448Medicare UPIN