Provider Demographics
NPI:1124137088
Name:KAUFFMAN, STUART A (DO)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:A
Last Name:KAUFFMAN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 S HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-4446
Mailing Address - Country:US
Mailing Address - Phone:727-219-1833
Mailing Address - Fax:727-330-2908
Practice Address - Street 1:855 S HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-4446
Practice Address - Country:US
Practice Address - Phone:727-219-1833
Practice Address - Fax:727-330-2908
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009083L207Q00000X, 207Q00000X
FLOS21088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA698304Medicare ID - Type Unspecified
PAG43994Medicare UPIN