=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124137088
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STUART A. KAUFFMAN D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 03/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 855 S HIGHLAND AVE
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33756-4446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-219-1833
-----------------------------------------------------
Fax | 727-330-2908
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 855 S HIGHLAND AVE
-----------------------------------------------------
City | CLEARWATER
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33756-4446
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-219-1833
-----------------------------------------------------
Fax | 727-330-2908
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | OS009083L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | OS21088
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------