MEDICARE: DR. BETTY KUPRACZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME147658	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043315203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETTY KUPRACZ MD

Provider Business Mailing Address
First Line	:	6376 PINE RIDGE RD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3908
Country	:	US
Telephone Number	:	239-239-4221
Fax Number	:	239-348-4433

Provider Business Practice Location Address
First Line	:	6376 PINE RIDGE RD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34119-3908
Country	:	US
Telephone Number	:	239-239-4221
Fax Number	:	239-348-4433

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	09/05/2025

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