MEDICARE: DR. SCOTT KOPPEL D.P.M.

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	202K00000X	Phlebology Physician	P02501	FL
2	213ES0103X	Foot & Ankle Surgery Podiatrist	P02501	FL
3	213E00000X	Podiatrist	PO 2501	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00693755	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1295732741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT KOPPEL D.P.M.

Provider Business Mailing Address
First Line	:	500 NW 43RD STREET
Second Line	:	STE 2
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-6126
Country	:	US
Telephone Number	:	352-376-5112
Fax Number	:	352-376-0320

Provider Business Practice Location Address
First Line	:	500 NW 43RD STREET
Second Line	:	STE 2
City	:	GAINESVILLE
State	:	FL
Zip	:	32607-6126
Country	:	US
Telephone Number	:	352-376-5112
Fax Number	:	352-376-0320

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	11/06/2025

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Directions to “ DR. SCOTT KOPPEL D.P.M.” Practice Location

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