Provider Demographics
NPI:1720784937
Name:KAPLAN, RANDY
Entity type:Individual
Prefix:MRS
First Name:RANDY
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 SANDPIPER CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1666
Mailing Address - Country:US
Mailing Address - Phone:305-298-0888
Mailing Address - Fax:
Practice Address - Street 1:1510 SANDPIPER CIR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-1666
Practice Address - Country:US
Practice Address - Phone:305-298-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND3082133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL721103Medicaid
FL721103OtherREGISTERED DIETITIAN