Provider Demographics
NPI:1245223205
Name:KORNFELD, STEPHEN JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JEFFREY
Last Name:KORNFELD
Suffix:
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 1:34041 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE D
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-2648
Mailing Address - Country:US
Mailing Address - Phone:727-787-6744
Mailing Address - Fax:727-786-3561
Practice Address - Street 1:34041 US HIGHWAY 19 N
Practice Address - Street 2:SUITE D
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-2648
Practice Address - Country:US
Practice Address - Phone:727-787-6744
Practice Address - Fax:727-786-3561
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0040107207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0205005OtherUNITED HEALTHCARE #
FL62366OtherBC/BS PROVIDER #
FL62366AMedicare ID - Type UnspecifiedMEDICARE PROVIDER #
FL62366OtherBC/BS PROVIDER #