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General NPI Number Information
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NPI Number | 1700414067
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Entity Type | Individual
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Provider Name | HUNTER RAFOTH MD
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Gender | Male
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 5565 N WICKHAM RD
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City | MELBOURNE
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State | FL
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Zip | 32940-7304
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Country | US
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Telephone | 321-843-5851
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Fax | 407-573-3355
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Provider Business Mailing Address
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Address Line | 60 COLUMBIA ST STE 400
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City | ORLANDO
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State | FL
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Zip | 32806-1115
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Country | US
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Telephone | 321-843-5851
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Fax | 321-843-7381
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2023-00836
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 2023-00836
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | ME152929
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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