MEDICARE: JASON D. KIEFFER MD

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	207N00000X	Dermatology Physician	ME163122	FL

General Provider Information

NPI Number	:	1215277454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON D. KIEFFER MD

Provider Business Mailing Address
First Line	:	151 SOUTHHALL LN STE 300
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-7172
Country	:	US
Telephone Number	:	866-400-3376
Fax Number	:	407-650-3455

Provider Business Practice Location Address
First Line	:	1410 W BROADWAY ST STE 205
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6472
Country	:	US
Telephone Number	:	866-400-3376
Fax Number	:	407-359-5445

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

Provider Enumeration Date	:	02/26/2013
Last Update Date	:	09/15/2025

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