Provider Demographics
NPI:1891916284
Name:KAPLAN, SCOTT M (PSYD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:KAPLAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 ROBERT J CONLAN BLVD NE STE 101
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-3563
Mailing Address - Country:US
Mailing Address - Phone:321-676-3474
Mailing Address - Fax:321-676-3412
Practice Address - Street 1:1581 ROBERT J CONLAN BLVD NE STE 101
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-3563
Practice Address - Country:US
Practice Address - Phone:321-676-3474
Practice Address - Fax:321-676-3412
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003736103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73318Medicare ID - Type Unspecified