Provider Demographics
NPI:1942475140
Name:KAUFMAN, SETH D (DO)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:D
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:130 RIDGE CENTER DR STE 206
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-6416
Mailing Address - Country:US
Mailing Address - Phone:786-706-5531
Mailing Address - Fax:786-706-1070
Practice Address - Street 1:130 RIDGE CENTER DR STE 207
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-6416
Practice Address - Country:US
Practice Address - Phone:786-706-5531
Practice Address - Fax:786-706-1070
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-28
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS106952081P2900X, 208VP0000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL016377500Medicaid