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NPI Code Detail

MEDICARE: REGINA KAUFMAN M.A.

MEDICARE: REGINA KAUFMAN M.A.
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
1222Q00000XDevelopmental Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871902486
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA KAUFMAN M.A.
Provider Business Mailing Address
First Line : 312 KEELERS CT
Second Line :
City : PONTE VEDRA BEACH
State : FL
Zip : 32082-2180
Country : US
Telephone Number : 904-285-0619
Fax Number :
Provider Business Practice Location Address
First Line : 1212 13TH ST N
Second Line :
City : JACKSONVILLE BEACH
State : FL
Zip : 32250-3682
Country : US
Telephone Number : 727-741-4305
Fax Number : 904-306-7826
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2014
Last Update Date : 08/07/2014

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