Provider Demographics
NPI:1770872467
Name:RAFFA, SCOTT JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:JOSEPH
Last Name:RAFFA
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 1:901 45TH ST - KIMMEL BUILDING
Mailing Address - Street 2:PALEY ORTHOPEDIC SPINE INSTITUTE - RE: AMANDA GLOVER
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407
Mailing Address - Country:US
Mailing Address - Phone:561-844-5255
Mailing Address - Fax:
Practice Address - Street 1:901 45TH STREET
Practice Address - Street 2:KIMMEL BUILDING
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407
Practice Address - Country:US
Practice Address - Phone:561-844-5255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 124486207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101050100Medicaid