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General NPI Number Information
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NPI Number | 1063737682
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Entity Type | Individual
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Provider Name | JOHN C MAVROPOULOS M.D., M.P.H., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 2121 S HIAWASSEE RD APT 4601
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City | ORLANDO
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State | FL
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Zip | 32835-8768
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Country | US
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Telephone | 443-435-3517
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Fax |
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Provider Business Mailing Address
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Address Line | 2121 S HIAWASSEE RD APT 4601
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City | ORLANDO
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State | FL
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Zip | 32835-8768
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Country | US
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Telephone | 443-435-3517
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | ME 124728
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License Number State | FL
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