MEDICARE: MS. DEBORAH LYNNE ROLFE M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35.128312	OH
2	207Q00000X	Family Medicine Physician	2016-00762	NC
3	207Q00000X	Family Medicine Physician	49368	KY
4	207Q00000X	Family Medicine Physician	39287	SC
5	207Q00000X	Family Medicine Physician	ME0074209	FL
6	207Q00000X	Family Medicine Physician	26979	WV
7	207Q00000X	Family Medicine Physician	53828	TN
8	207Q00000X	Family Medicine Physician	MD043823	DC
9	207Q00000X	Family Medicine Physician	17733	NH
10	207Q00000X	Family Medicine Physician	0101261212	VA
11	207Q00000X	Family Medicine Physician	075882	GA
12	207Q00000X	Family Medicine Physician	E10294	AR

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1275586604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH LYNNE ROLFE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1239
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48099-1239
Country	:	US
Telephone Number	:	248-824-6600
Fax Number	:	855-618-6655

Provider Business Practice Location Address
First Line	:	4348 SOUTHPOINT BLVD
Second Line	:	SUITE 100
City	:	JACKSONVILLE
State	:	FL
Zip	:	32216-0986
Country	:	US
Telephone Number	:	904-281-1915
Fax Number	:	904-281-1119

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	08/12/2019