Provider Demographics
NPI:1902903446
Name:CAPLIVSKI, GERTRUDE (MD)
Entity type:Individual
Prefix:
First Name:GERTRUDE
Middle Name:
Last Name:CAPLIVSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 NE 32ND AVE
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33305-1854
Mailing Address - Country:US
Mailing Address - Phone:954-599-1088
Mailing Address - Fax:954-565-3867
Practice Address - Street 1:2131 NE 32ND AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33305-1854
Practice Address - Country:US
Practice Address - Phone:954-599-1088
Practice Address - Fax:954-565-3867
Is Sole Proprietor?:No
Enumeration Date:2006-09-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 26656207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI24228Medicare UPIN
FL44488ZMedicare ID - Type Unspecified