Provider Demographics
NPI:1972560720
Name:KAPULSKEY, SCOTT EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:EVAN
Last Name:KAPULSKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7035 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-1203
Mailing Address - Country:US
Mailing Address - Phone:727-345-6337
Mailing Address - Fax:727-347-0403
Practice Address - Street 1:1615 PASADENA AVE S STE 350
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-4521
Practice Address - Country:US
Practice Address - Phone:727-345-6337
Practice Address - Fax:727-347-0403
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05001100207QG0300X, 207QG0300X
FLME108182207QG0300X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002803600Medicaid
FLDV024WMedicare UPIN
E22084Medicare UPIN