Provider Demographics
NPI:1902821721
Name:PETER R KAPLAN PH D PA
Entity Type:Organization
Organization Name:PETER R KAPLAN PH D PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:R
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:941-953-4313
Mailing Address - Street 1:100 N WASHINGTON BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236-5807
Mailing Address - Country:US
Mailing Address - Phone:941-953-4313
Mailing Address - Fax:941-954-8631
Practice Address - Street 1:100 N WASHINGTON BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-5807
Practice Address - Country:US
Practice Address - Phone:941-953-4313
Practice Address - Fax:941-954-8631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4229103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4807Medicare ID - Type Unspecified