Provider Demographics
NPI:1336234731
Name:KAUFMAN, SANFORD LESLIE
Entity type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:LESLIE
Last Name:KAUFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9804 S. MILITARY TRAIL #E-7
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436
Mailing Address - Country:US
Mailing Address - Phone:561-738-5997
Mailing Address - Fax:561-738-5951
Practice Address - Street 1:9804 S. MILITARY TRAIL #E-7
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436
Practice Address - Country:US
Practice Address - Phone:561-738-5997
Practice Address - Fax:561-738-5951
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2009-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1287152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBM679OtherGROUP PTAN
FLT-8410Medicare UPIN
FL19668ZMedicare PIN