Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME125095 | FL |
N | 207X00000X | Orthopaedic Surgeon | MT195641 | PA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME125095 | FL |
NPI | 1306072129 |
---|---|
Provider Name | Samuel Paul Popinchalk |
First Address | Aventura, FL 33180-1204 |
Second Address | Aventura, FL 33180-1204 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 13/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ME125095 | FLORIDA STATE BOARD OF MEDICINE (01) | FL |
MT195641 | PENNSYLVANIA STATE MEDICAL LICENSE (01) | PA |