Provider Demographics
NPI:1285669143
Name:KAPLAN, KELBY BROOKE (MPT, COMT, OCS)
Entity Type:Individual
Prefix:
First Name:KELBY
Middle Name:BROOKE
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MPT, COMT, OCS
Other - Prefix:
Other - First Name:KELBY
Other - Middle Name:BROOKE
Other - Last Name:SHAMASH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT, COMT, OCS
Mailing Address - Street 1:6295 C DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8717
Mailing Address - Country:US
Mailing Address - Phone:561-324-0799
Mailing Address - Fax:
Practice Address - Street 1:6295 C DURHAM DR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467
Practice Address - Country:US
Practice Address - Phone:561-324-0799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21779225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist