Provider Demographics
NPI:1689844359
Name:KAPLAN, LISA
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2881 S BUMBY AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-8704
Mailing Address - Country:US
Mailing Address - Phone:407-894-0005
Mailing Address - Fax:407-894-7759
Practice Address - Street 1:2881 S BUMBY AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-8704
Practice Address - Country:US
Practice Address - Phone:407-894-0005
Practice Address - Fax:407-894-7759
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1680282363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCZ626ZOtherMEDICARE PART B