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General NPI Number Information
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NPI Number | 1174718480
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Entity Type | Individual
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Provider Name | DIANA CONSTANZA KOOPER M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 350 7TH ST N
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City | NAPLES
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State | FL
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Zip | 34102-5754
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Country | US
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Telephone | 239-624-3997
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Fax | 239-624-8101
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Provider Business Mailing Address
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Address Line | PO BOX 112019
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City | NAPLES
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State | FL
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Zip | 34108-0134
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Country | US
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Telephone |
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Fax | 239-624-0464
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 0101259408
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 48309
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 48309
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101259408
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME104136
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License Number State | FL
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