Provider Demographics
NPI:1033108774
Name:KAPLAN, HAROLD JACK (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:JACK
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 AVE DES PARQUES N
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-1701
Mailing Address - Country:US
Mailing Address - Phone:941-488-5608
Mailing Address - Fax:941-488-6622
Practice Address - Street 1:200 AVE DES PARQUES N
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-1701
Practice Address - Country:US
Practice Address - Phone:941-488-5608
Practice Address - Fax:941-488-6622
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-15
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL43971207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL58485Medicare ID - Type UnspecifiedPROVIDE ID
FLD64539Medicare UPIN