Individual
BRYAN LEE KAUFMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4136 STOWE RUN LN, JACKSONVILLE, FL 32225-1622
(828) 389-9740
(866) 735-3451
Mailing address
4136 STOWE RUN LN, STE 204, JACKSONVILLE, FL 32225-1622
(216) 255-5743
(866) 735-3451
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME74867
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259066200
—
FL
01
—
300110020
RR
—
01
—
43420
BCBS
—
Enumeration date
07/07/2005
Last updated
02/13/2017
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