Basic Information
Provider Information
NPI: 1952410789
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHAPLIK
FirstName: IGOR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 151 SOUTHHALL LN STE 300
Address2:  
City: MAITLAND
State: FL
PostalCode: 327517172
CountryCode: US
TelephoneNumber: 4078752080
FaxNumber: 4078750518
Practice Location
Address1: 4331 N FEDERAL HWY STE 400
Address2:  
City: FT LAUDERDALE
State: FL
PostalCode: 33308
CountryCode: US
TelephoneNumber: 9547720416
FaxNumber: 9547725716
Other Information
ProviderEnumerationDate: 08/29/2006
LastUpdateDate: 08/27/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000XOS9145FLY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


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