Provider Demographics
NPI:1235399114
Name:KAUFMAN, MARINA S (MD)
Entity type:Individual
Prefix:DR
First Name:MARINA
Middle Name:S
Last Name:KAUFMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3466 N HARBOR CITY BLVD
Mailing Address - Street 2:CREDENTIALING
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5713
Mailing Address - Country:US
Mailing Address - Phone:321-434-1981
Mailing Address - Fax:321-951-7408
Practice Address - Street 1:9800 S HEALTHPARK DR STE 110
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-3630
Practice Address - Country:US
Practice Address - Phone:239-343-6202
Practice Address - Fax:239-343-4159
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2024-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME116011207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103478900Medicaid