Healthcare Provider Details

I. General information

NPI: 1699088997
Provider Name (Legal Business Name): RACHEL KAPLAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2010
Last Update Date: 12/11/2019
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HEALTH PARK BLVD STE 3002
ST AUGUSTINE FL
32086-3703
US

IV. Provider business mailing address

300 HEALTH PARK BLVD STE 3002
ST AUGUSTINE FL
32086-3703
US

V. Phone/Fax

Practice location:
  • Phone: 904-819-1500
  • Fax: 904-810-1023
Mailing address:
  • Phone: 604-819-1500
  • Fax: 904-810-1023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101018993
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34-011390
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS16199
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: