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General NPI Number Information
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NPI Number | 1417021114
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Entity Type | Organization
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Legal Business Name | KOPA LLC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 12/22/2023
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Provider Practice Location Address
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Address Line | 5900 LAKE ELLENOR DR STE 700
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City | ORLANDO
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State | FL
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Zip | 32809-4643
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Country | US
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Telephone | 407-352-2542
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Fax | 844-556-8650
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Provider Business Mailing Address
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Address Line | 5900 LAKE ELLENOR DR STE 700
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City | ORLANDO
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State | FL
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Zip | 32809-4643
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Country | US
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Telephone | 407-352-2542
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Fax | 844-556-8650
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY L BIEGASIEWICZ
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Credential |
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Telephone | 407-216-0101
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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