Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | ME0092699 | FL |
NPI | 1053364232 |
---|---|
Provider Name | Dr. Robert Kopec |
First Address | Clearwater, FL 33757-8744 |
Second Address | Safety Harbor, FL 34695-6607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 09/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
272267400 | (05) | FL |
I39465 | (02) | FL |
P01063607 | MEDICARE RAILROAD PROVIDER NUMBER (01) | FL |