Provider Demographics
NPI:1336188770
Name:KAPROW, MARC G (DO)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:G
Last Name:KAPROW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 292083
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33329-2083
Mailing Address - Country:US
Mailing Address - Phone:877-868-4827
Mailing Address - Fax:877-283-0663
Practice Address - Street 1:5430 NW 33RD AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-6349
Practice Address - Country:US
Practice Address - Phone:877-868-4827
Practice Address - Fax:877-283-0663
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS-9129207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL273485100Medicaid
FL273485100Medicaid