Provider Demographics
NPI:1528198959
Name:STANLEY M. KAPLAN DPM PA
Entity Type:Organization
Organization Name:STANLEY M. KAPLAN DPM PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-831-4118
Mailing Address - Street 1:4202 W WATERS AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1972
Mailing Address - Country:US
Mailing Address - Phone:813-887-5511
Mailing Address - Fax:813-832-2932
Practice Address - Street 1:4202 W WATERS AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1972
Practice Address - Country:US
Practice Address - Phone:813-887-5511
Practice Address - Fax:813-832-2932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 0001248213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL041208200Medicaid
FLPO 001248OtherLICENSE
1710918578OtherPERSONAL NPI
FL041208200Medicaid
FLK9152Medicare ID - Type Unspecified
FL4043430001Medicare NSC