Provider Demographics
NPI:1598054603
Name:KAUFMAN, MARC VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:VICTOR
Last Name:KAUFMAN
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 1:1209 E CUMBERLAND AVE
Mailing Address - Street 2:UNIT 606
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4256
Mailing Address - Country:US
Mailing Address - Phone:954-254-7738
Mailing Address - Fax:
Practice Address - Street 1:12901 BRUCE B DOWNS BLVD # 41
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4742
Practice Address - Country:US
Practice Address - Phone:813-844-7412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-30
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME120481207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology