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General NPI Number Information
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NPI Number | 1326316183
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Entity Type | Organization
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Legal Business Name | RAFAEL J NOBO JR M.D., P.A.
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 12/15/2011
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Provider Practice Location Address
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Address Line | 222 W MAIN ST SUITE B
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City | BARTOW
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State | FL
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Zip | 33830-4531
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Country | US
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Telephone | 863-533-8944
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Fax | 863-533-1577
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Provider Business Mailing Address
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Address Line | 222 W MAIN ST SUITE B
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City | BARTOW
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State | FL
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Zip | 33830-4531
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Country | US
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Telephone | 863-533-8944
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Fax | 863-533-1577
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. RAFAEL J NOBO JR.
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Credential | M.D., P.A.
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Telephone | 863-533-8944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME41315
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License Number State | FL
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