Provider Demographics
NPI:1912103789
Name:KAUFMAN, MILTON (OTRL)
Entity Type:Individual
Prefix:MR
First Name:MILTON
Middle Name:
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5702 LAKE WORTH RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3269
Mailing Address - Country:US
Mailing Address - Phone:561-967-4441
Mailing Address - Fax:561-967-4405
Practice Address - Street 1:5702 LAKE WORTH RD
Practice Address - Street 2:SUITE 11
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3269
Practice Address - Country:US
Practice Address - Phone:561-967-4441
Practice Address - Fax:561-967-4405
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0006480225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ8570Medicare ID - Type UnspecifiedOTRL