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General NPI Number Information
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NPI Number | 1639102114
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Entity Type | Individual
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Provider Name | RAFE GAROFALO OD
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Gender | Male
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 20260 S ELLSWORTH RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-8840
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Country | US
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Telephone | 480-847-1015
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Fax |
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Provider Business Mailing Address
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Address Line | 20260 S ELLSWORTH RD
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-8840
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Country | US
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Telephone | 480-847-1015
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2612
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT-002847
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License Number State | AZ
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