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General NPI Number Information
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NPI Number | 1629227269
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Entity Type | Organization
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Legal Business Name | KENNETH S. JAFFE, M.D., P.A.
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 10301 HAGEN RANCH RD SUITE B-550
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City | BOYNTON BEACH
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State | FL
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Zip | 33437-3724
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Country | US
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Telephone | 561-374-8677
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Fax | 561-374-8796
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Provider Business Mailing Address
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Address Line | 130 JFK DR SUITE 134
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City | ATLANTIS
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State | FL
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Zip | 33462-1141
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Country | US
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Telephone | 561-439-0308
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Fax | 561-439-0371
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH SCOTT JAFFE
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Credential | M.D.
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Telephone | 561-439-0308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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