MEDICARE: KENNETH ALAN RAPPAPORT D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME43853	FL
2	207RN0300X	Nephrology Physician	ME0043853	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447210372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH ALAN RAPPAPORT D.O.

Provider Business Mailing Address
First Line	:	3401 PGA BLVD STE 310
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2824
Country	:	US
Telephone Number	:	561-296-8042
Fax Number	:	561-766-2159

Provider Business Practice Location Address
First Line	:	3401 PGA BLVD STE 310
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2824
Country	:	US
Telephone Number	:	561-296-8042
Fax Number	:	561-766-2159

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	09/24/2021

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Directions to “ KENNETH ALAN RAPPAPORT D.O.” Practice Location

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