Provider Demographics
NPI:1194903864
Name:SANFORD I RAKOFSKY MD PA
Entity type:Organization
Organization Name:SANFORD I RAKOFSKY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:I
Authorized Official - Last Name:RAKOFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-442-9020
Mailing Address - Street 1:401 MIRACLE MILE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-4930
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:SUITE 301
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-4930
Practice Address - Country:US
Practice Address - Phone:305-442-9020
Practice Address - Fax:305-442-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1116070001Medicare NSC