MEDICARE: DR. CHRISTOPHER IRA KAUFFMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MD424452	PA
2	2084P0800X	Psychiatry Physician	52255	SC
3	2084P0800X	Psychiatry Physician	214959	NY
4	2084P0800X	Psychiatry Physician	ME90437	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720081987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER IRA KAUFFMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2147
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-2147
Country	:	US
Telephone Number	:	239-424-1479
Fax Number	:	239-343-9193

Provider Business Practice Location Address
First Line	:	9981 S HEALTHPARK DR
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3618
Country	:	US
Telephone Number	:	239-343-2062
Fax Number	:	239-343-9193

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/10/2022

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