Provider Demographics
NPI:1184465882
Name:KEITH B KAPPELER, D.O.
Entity type:Organization
Organization Name:KEITH B KAPPELER, D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:KAPPELER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-595-5600
Mailing Address - Street 1:13201 WALSINGHAM RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-3515
Mailing Address - Country:US
Mailing Address - Phone:727-595-5600
Mailing Address - Fax:727-674-1823
Practice Address - Street 1:13201 WALSINGHAM RD STE 100
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33774-3515
Practice Address - Country:US
Practice Address - Phone:727-595-5600
Practice Address - Fax:727-674-1823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty