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NPI Code Detail

MEDICARE: NANCY LEE KOPITNIK DO

MEDICARE: NANCY LEE KOPITNIK DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1204C00000XSports Medicine (Neuromusculoskeletal Medicine) PhysicianOS6229FL
2207QH0002XHospice and Palliative Medicine (Family Medicine) PhysicianOS6229FL
3207RA0401XAddiction Medicine (Internal Medicine) PhysicianOS6229FL
4208D00000XGeneral Practice PhysicianOS6229FL
5208VP0000XPain Medicine PhysicianOS6229FL

General Provider Information

NPI Number : 1518942036
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY LEE KOPITNIK DO
Provider Business Mailing Address
First Line : 157 BALTIMORE ST STE 102
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-2472
Country : US
Telephone Number : 301-722-0484
Fax Number : 833-903-0130
Provider Business Practice Location Address
First Line : 1507 S TUTTLE AVE
Second Line :
City : SARASOTA
State : FL
Zip : 34239-2608
Country : US
Telephone Number : 301-722-0484
Fax Number : 833-903-0130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 08/15/2025

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