MEDICARE: ALEX ZOPO 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
1	207R00000X	Internal Medicine Physician	ME 81037	FL

General Provider Information

NPI Number	:	1184658718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEX ZOPO M.D.

Provider Business Mailing Address
First Line	:	11195 S JOG RD
Second Line	:	SUITE 3
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-1829
Country	:	US
Telephone Number	:	561-736-8600
Fax Number	:	561-736-7191

Provider Business Practice Location Address
First Line	:	11195 S JOG RD
Second Line	:	SUITE 3
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-1829
Country	:	US
Telephone Number	:	561-736-8600
Fax Number	:	561-736-7191

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/13/2012

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