Healthcare Provider Details

I. General information

NPI: 1467080697
Provider Name (Legal Business Name): JOHN KAPANIRIS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 SR 580 STE 202
CLEARWATER FL
33761
US

IV. Provider business mailing address

2655 SR 580 STE 202
CLEARWATER FL
33761
US

V. Phone/Fax

Practice location:
  • Phone: 727-266-5449
  • Fax:
Mailing address:
  • Phone: 727-266-5449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS20161
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: