Healthcare Provider Details

I. General information

NPI: 1942005756
Provider Name (Legal Business Name): GEORGENA DOPYERA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 JENKS AVE
PANAMA CITY FL
32401-2441
US

IV. Provider business mailing address

2403 GRANDIFLORA BLVD
PANAMA CITY BEACH FL
32408-7078
US

V. Phone/Fax

Practice location:
  • Phone: 888-772-4273
  • Fax:
Mailing address:
  • Phone: 713-444-5340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: