Doctor Name: | ANTHONY J COPPOLA |
NPI Number: | 1801895917 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | ME54590 |
Business Practice Address: | 515 W State Road 434 Suite 110a Longwood, FL - 327504981 |
Business Phone Number: | 4072606000 |
Business Fax Number: | 4072602133 |
Mailing Address: | 515 W State Road 434, Suite 110a LONGWOOD |
State: | FL |
Postal Code: | 327504981 |
Phone Number: | 4072606000 |
Fax Number: | 4072602133 |
NPI Enumeration Date: | 07/20/2005 |
NPI Last Update Date: | 06/04/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ME54590 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |