Provider Demographics
NPI:1578741054
Name:FAMILY PODIATRY OF CENTRAL FLORIDA PA
Entity Type:Organization
Organization Name:FAMILY PODIATRY OF CENTRAL FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:321-397-2699
Mailing Address - Street 1:450 W CENTRAL PKWY STE 1000
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2433
Mailing Address - Country:US
Mailing Address - Phone:321-397-2699
Mailing Address - Fax:407-926-0500
Practice Address - Street 1:450 W CENTRAL PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2433
Practice Address - Country:US
Practice Address - Phone:321-397-2699
Practice Address - Fax:407-926-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340201100Medicaid
65631YMedicare UPIN
FL340201100Medicaid