Provider Demographics
NPI:1962455824
Name:JAFFE, GARY F (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:F
Last Name:JAFFE
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 1:2801 NE 213TH ST STE 1006
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1266
Mailing Address - Country:US
Mailing Address - Phone:305-945-7433
Mailing Address - Fax:305-933-0895
Practice Address - Street 1:2801 NE 213TH ST STE 1006
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1266
Practice Address - Country:US
Practice Address - Phone:305-945-7433
Practice Address - Fax:305-933-0895
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38393207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3768210-00Medicaid
FL95960YMedicare PIN
FLD63676Medicare UPIN
FL95960XMedicare PIN