Provider Demographics
NPI:1427233444
Name:SANFORD L KAUFMAN OD PA
Entity Type:Organization
Organization Name:SANFORD L KAUFMAN OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SANFORD
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAUFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:561-738-5997
Mailing Address - Street 1:9804 S MILITARY TRL STE E7
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436-3220
Mailing Address - Country:US
Mailing Address - Phone:561-738-5997
Mailing Address - Fax:561-738-5951
Practice Address - Street 1:9804 S MILITARY TRL STE E7
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-3220
Practice Address - Country:US
Practice Address - Phone:561-738-5997
Practice Address - Fax:561-738-5951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 1287152W00000X
FL1287332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT84106Medicare UPIN
FL0708500001Medicare NSC
FL19668Medicare PIN