Provider Demographics
NPI:1922005321
Name:NORFLEET, DAVID ALLEN (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLEN
Last Name:NORFLEET
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1639 LAHAINA CT
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-4916
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 E REDSTONE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CRESTVIEW
Practice Address - State:FL
Practice Address - Zip Code:32539-5357
Practice Address - Country:US
Practice Address - Phone:850-689-8004
Practice Address - Fax:850-689-8068
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8458208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262439700Medicaid
E37146Medicare UPIN
FL262439700Medicaid