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NPI Code Detail

MEDICARE: DR. GERALD MARCUS COPELAND II D.M.D.

MEDICARE:  DR. GERALD MARCUS COPELAND II  D.M.D.
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
11223P0221XPediatric Dentistry15386FL

General Provider Information

NPI Number : 1144223124
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD MARCUS COPELAND II D.M.D.
Provider Business Mailing Address
First Line : 4501 N ARMENIA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33603-2744
Country : US
Telephone Number : 813-879-7167
Fax Number : 813-871-5154
Provider Business Practice Location Address
First Line : 4501 N ARMENIA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33603-2744
Country : US
Telephone Number : 813-879-7167
Fax Number : 813-871-5154
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/08/2007

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Directions to “ DR. GERALD MARCUS COPELAND II D.M.D.” Practice Location

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