Provider Demographics
NPI:1033105374
Name:COMFORT, JOSEPH ALBERT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ALBERT
Last Name:COMFORT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 MEDICAL PLAZA DR STE 108
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-1085
Mailing Address - Country:US
Mailing Address - Phone:407-330-6500
Mailing Address - Fax:
Practice Address - Street 1:1403 MEDICAL PLAZA DR STE 108
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-1085
Practice Address - Country:US
Practice Address - Phone:407-330-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 37327207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL039895100Medicaid
FL039895100Medicaid
FL35175WMedicare PIN