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General NPI Number Information
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NPI Number | 1700454337
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Entity Type | Individual
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Provider Name | JOHN COPPETA DPT
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Gender | Male
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 20195 CORTEZ BLVD
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City | BROOKSVILLE
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State | FL
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Zip | 34601-3850
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Country | US
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Telephone | 352-754-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 660 EDGEMERE DR
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City | ROCHESTER
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State | NY
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Zip | 14612-1722
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Country | US
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Telephone | 585-309-5103
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT39667
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License Number State | FL
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