Provider Demographics
NPI:1235628314
Name:KAPLAN, MARK A (PHARM D)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11158 PALMETTO RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1371
Mailing Address - Country:US
Mailing Address - Phone:239-293-9284
Mailing Address - Fax:
Practice Address - Street 1:107 W MAIN ST
Practice Address - Street 2:
Practice Address - City:IMMOKALEE
Practice Address - State:FL
Practice Address - Zip Code:34142-3926
Practice Address - Country:US
Practice Address - Phone:239-658-1048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-04
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS33342OtherBOARD OF PHARMACY