Healthcare Provider Details

I. General information

NPI: 1760444699
Provider Name (Legal Business Name): STANISLAW HOPPE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 S KIRKMAN RD
ORLANDO FL
32811-2346
US

IV. Provider business mailing address

8106 LAKE SERENE DR
ORLANDO FL
32836-5019
US

V. Phone/Fax

Practice location:
  • Phone: 407-362-2030
  • Fax: 407-362-2040
Mailing address:
  • Phone: 407-345-0655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME69043
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: