Healthcare Provider Details

I. General information

NPI: 1316203128
Provider Name (Legal Business Name): JEFFREY A KAUFMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11215 METRO PKWY BLDG. 3, STE 1
FORT MYERS FL
33966
US

IV. Provider business mailing address

11215 METRO PKWY BLDG. 3, STE 1
FORT MYERS FL
33966
US

V. Phone/Fax

Practice location:
  • Phone: 239-208-2212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberD83068
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME182609
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number81527
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD458876
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: