MEDICARE: DR. JONATHAN RAKOFSKY M.D.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	4301100351	MI
2	207P00000X	Emergency Medicine Physician	MD048800	DC

Other Identifiers

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

General Provider Information

NPI Number	:	1790044550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN RAKOFSKY M.D.

Provider Business Mailing Address
First Line	:	3641 S MIAMI AVE
Second Line	:	EMERGENCY DEPARTMENT
City	:	MIAMI
State	:	FL
Zip	:	33133-4204
Country	:	US
Telephone Number	:	313-916-2600
Fax Number	:

Provider Business Practice Location Address
First Line	:	3641 S MIAMI AVE
Second Line	:	EMERGENCY DEPARTMENT
City	:	MIAMI
State	:	FL
Zip	:	33133-4204
Country	:	US
Telephone Number	:	313-916-2600
Fax Number	:

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

Provider Enumeration Date	:	05/14/2012
Last Update Date	:	03/11/2022

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