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General NPI Number Information
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NPI Number | 1578998126
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Entity Type | Organization
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Legal Business Name | ANGELO COPPOLA, MD, PSC
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Dates
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Enumeration Date | 09/13/2013
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Last Update Date | 09/13/2013
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Provider Practice Location Address
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Address Line | A28 CALLE C JARDINES DE CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00987-7102
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Country | US
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Telephone | 787-257-2040
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Fax | 787-750-4126
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Provider Business Mailing Address
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Address Line | A28 CALLE C JARDINES DE CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00987-7102
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Country | US
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Telephone | 787-257-2040
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Fax | 787-750-4126
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Authorized Official
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Title or Position | SOLE OWNER
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Name | DR. ANGELO COPPOLA
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Credential | M.D.
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Telephone | 787-257-2040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 8825
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License Number State | PR
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