MEDICARE: DAVID COPPOLA DC

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	111N00000X	Chiropractor	CH0007249	FL
2	171100000X	Acupuncturist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1205032570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID COPPOLA DC

Provider Business Mailing Address
First Line	:	103400 OVERSEAS HWY
Second Line	:	SUITE 241
City	:	KEY LARGO
State	:	FL
Zip	:	33037-2834
Country	:	US
Telephone Number	:	305-451-1819
Fax Number	:

Provider Business Practice Location Address
First Line	:	103400 OVERSEAS HWY
Second Line	:	SUITE 241
City	:	KEY LARGO
State	:	FL
Zip	:	33037-2834
Country	:	US
Telephone Number	:	305-451-1819
Fax Number	:

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	05/17/2016

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Directions to “ DAVID COPPOLA DC” Practice Location

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