Provider Demographics
NPI:1649678699
Name:MEDICAL AFFILIATES
Entity type:Organization
Organization Name:MEDICAL AFFILIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-781-6908
Mailing Address - Street 1:50 NE 26TH AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-5226
Mailing Address - Country:US
Mailing Address - Phone:954-781-6908
Mailing Address - Fax:954-781-6909
Practice Address - Street 1:50 NE 26TH AVE STE 203
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-5226
Practice Address - Country:US
Practice Address - Phone:954-781-6908
Practice Address - Fax:954-781-6909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD79554OtherUPIN