Healthcare Provider Details
I. General information
NPI: 1952868200
Provider Name (Legal Business Name): DALE M KAPLAN DPM LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/22/2019
Last Update Date: 02/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4311 BAYOU BLVD APT A8
PENSACOLA FL
32503-2621
US
IV. Provider business mailing address
882 W SUNSET STRIP DR
BEVERLY HILLS FL
34465-8745
US
V. Phone/Fax
- Phone: 248-931-0910
- Fax:
- Phone: 248-931-0910
- Fax: 727-573-2048
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0103X |
| Taxonomy | Foot & Ankle Surgery Podiatrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DALE
M
KAPLAN
Title or Position: SOLE MBR
Credential: DPM
Phone: 248-931-0901