Provider Demographics
NPI:1881855617
Name:MICHAEL W. KEMPLIN, MD, PA
Entity Type:Organization
Organization Name:MICHAEL W. KEMPLIN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:KEMPLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-371-1115
Mailing Address - Street 1:PO BOX 7986
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34278-7986
Mailing Address - Country:US
Mailing Address - Phone:941-371-1115
Mailing Address - Fax:
Practice Address - Street 1:1283 JACARANDA BLVD
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-4522
Practice Address - Country:US
Practice Address - Phone:941-371-1115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL72510BMedicare PIN