MEDICARE: LAURA KAUFMAN DPT

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	2251X0800X	Orthopedic Physical Therapist	34134	FL

General Provider Information

NPI Number	:	1962979575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA KAUFMAN DPT

Provider Business Mailing Address
First Line	:	470 MALABAR RD SE UNIT 102
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-3124
Country	:	US
Telephone Number	:	321-802-9645
Fax Number	:

Provider Business Practice Location Address
First Line	:	470 MALABAR RD SE UNIT 102
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32907-3124
Country	:	US
Telephone Number	:	321-802-9645
Fax Number	:

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

Provider Enumeration Date	:	11/01/2018
Last Update Date	:	11/01/2018

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Directions to “ LAURA KAUFMAN DPT” Practice Location

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