Provider Demographics
NPI:1164697710
Name:KAUFMAN, GILBERT NEAL
Entity Type:Individual
Prefix:
First Name:GILBERT
Middle Name:NEAL
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26392 EXPLORER RD
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33983-6314
Mailing Address - Country:US
Mailing Address - Phone:941-979-9701
Mailing Address - Fax:
Practice Address - Street 1:26392 EXPLORER RD
Practice Address - Street 2:
Practice Address - City:PUNTA GORDA
Practice Address - State:FL
Practice Address - Zip Code:33983-6314
Practice Address - Country:US
Practice Address - Phone:941-979-9701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW19131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical