Provider Demographics
NPI:1174618151
Name:S. J. KORNFELD, M.D., INC.
Entity type:Organization
Organization Name:S. J. KORNFELD, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KORNFELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-787-6744
Mailing Address - Street 1:34041 U.S. HIGHWAY 19 NORTH
Mailing Address - Street 2:SUITE D
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684
Mailing Address - Country:US
Mailing Address - Phone:727-787-6744
Mailing Address - Fax:727-786-3561
Practice Address - Street 1:34041 U.S. HIGHWAY 19 NORTH
Practice Address - Street 2:SUITE D
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684
Practice Address - Country:US
Practice Address - Phone:727-787-6744
Practice Address - Fax:727-786-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40107207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX IDENTIFICATION NUMBER
FL00313Medicare ID - Type UnspecifiedMEDICARE GROUP I.D. #