Provider Demographics
NPI:1205958444
Name:RAFTOPOULOS, GERALD (DC)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:RAFTOPOULOS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 OKEECHOBEE BLVD
Mailing Address - Street 2:SUITE D-7
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2511
Mailing Address - Country:US
Mailing Address - Phone:561-684-1080
Mailing Address - Fax:561-684-6221
Practice Address - Street 1:6901 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE D-7
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2511
Practice Address - Country:US
Practice Address - Phone:561-684-1080
Practice Address - Fax:561-684-6221
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 8252111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL89348OtherBCBSFL
FL89348OtherBCBSFL
FL89348AMedicare PIN