Healthcare Provider Details

I. General information

NPI: 1548332497
Provider Name (Legal Business Name): TALYA H KUPIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6298 LINTON BLVD STE 102
DELRAY BEACH FL
33484-6444
US

IV. Provider business mailing address

6298 LINTON BLVD STE 102
DELRAY BEACH FL
33484-6444
US

V. Phone/Fax

Practice location:
  • Phone: 561-737-4040
  • Fax: 561-369-7104
Mailing address:
  • Phone: 561-479-3884
  • Fax: 561-479-3885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME79238
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: