Provider Demographics
NPI:1316002470
Name:JOHN DANIEL KEPLER, MD PA
Entity Type:Organization
Organization Name:JOHN DANIEL KEPLER, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:KEPLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-938-8806
Mailing Address - Street 1:2680 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-7335
Mailing Address - Country:US
Mailing Address - Phone:727-938-8806
Mailing Address - Fax:727-934-6370
Practice Address - Street 1:1501 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-3717
Practice Address - Country:US
Practice Address - Phone:727-938-8806
Practice Address - Fax:727-934-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0066269174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF87020Medicare UPIN