Provider Demographics
NPI:1558318014
Name:KAPLAN, PETER R (PHD)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:R
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 HYDE PARK ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3612
Mailing Address - Country:US
Mailing Address - Phone:941-953-4313
Mailing Address - Fax:941-954-8631
Practice Address - Street 1:1991 HYDE PARK ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3612
Practice Address - Country:US
Practice Address - Phone:941-953-4313
Practice Address - Fax:941-954-8631
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4229103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73570DMedicare PIN