Provider Demographics
NPI:1255301925
Name:KAPLAN, ANDREW M (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:M
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 BRANTLEY RD APT 1415
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3919
Mailing Address - Country:US
Mailing Address - Phone:978-771-3129
Mailing Address - Fax:
Practice Address - Street 1:1735 BRANTLEY ROAD, APT 1415
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907
Practice Address - Country:US
Practice Address - Phone:978-771-3129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAP1549363A00000X
FLPA9106073363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9524809OtherAETNA
FL004454600Medicaid
FLP938615OtherOPTIMUM
FLP997794OtherFREEDOM HEALTH
FLY09JROtherBCBS FL
FLP01033768OtherRAILROAD MCR
FLP938615OtherOPTIMUM
FLP997794OtherFREEDOM HEALTH
MAAP1889Medicare PIN