Provider Demographics
NPI:1972561330
Name:RAKOFSKY, SANFORD IRWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:IRWIN
Last Name:RAKOFSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MIRACLE MILE
Mailing Address - Street 2:#301
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-442-9020
Mailing Address - Fax:305-442-8284
Practice Address - Street 1:401 MIRACLE MILE
Practice Address - Street 2:#301
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:305-442-9020
Practice Address - Fax:305-442-8284
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLML0017340207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053203700Medicaid
D59714Medicare UPIN
FL053203700Medicaid