Provider Demographics
NPI:1205832862
Name:KAPLAN, MITCHELL L (DC)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:L
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360914
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32936-0914
Mailing Address - Country:US
Mailing Address - Phone:321-255-3003
Mailing Address - Fax:321-255-3005
Practice Address - Street 1:1565 SARNO RD.
Practice Address - Street 2:STE B
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935
Practice Address - Country:US
Practice Address - Phone:321-255-3003
Practice Address - Fax:321-255-3005
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL380957900Medicaid
T85852Medicare UPIN
FL380957900Medicaid