MEDICARE: GERTRUDE CAPLIVSKI MD

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	207ZP0101X	Anatomic Pathology Physician	ME 26656	FL

General Provider Information

NPI Number	:	1902903446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERTRUDE CAPLIVSKI MD

Provider Business Mailing Address
First Line	:	2131 NE 32ND AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33305-1854
Country	:	US
Telephone Number	:	954-599-1088
Fax Number	:	954-565-3867

Provider Business Practice Location Address
First Line	:	2131 NE 32ND AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33305-1854
Country	:	US
Telephone Number	:	954-599-1088
Fax Number	:	954-565-3867

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

Provider Enumeration Date	:	09/19/2006
Last Update Date	:	07/08/2007

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