MEDICARE: IVY KAPLAN B.C.B.A.

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	103K00000X	Behavior Analyst
2	222Q00000X	Developmental Therapist

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

General Provider Information

NPI Number	:	1871633529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVY KAPLAN B.C.B.A.

Provider Business Mailing Address
First Line	:	8130 ROYAL PALM BLVD STE 105
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-5703
Country	:	US
Telephone Number	:	954-344-6550
Fax Number	:	954-344-8634

Provider Business Practice Location Address
First Line	:	8130 ROYAL PALM BLVD STE 105
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-5703
Country	:	US
Telephone Number	:	954-344-6550
Fax Number	:	954-344-8634

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	06/14/2023

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