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NPI Code Detail

MEDICARE: CONNIE E POETTER MD

MEDICARE: CONNIE E POETTER 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
12084P0800XPsychiatry PhysicianME105257FL
22084P0805XGeriatric Psychiatry PhysicianME105257FL

Other Identifiers

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

General Provider Information

NPI Number : 1407019383
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE E POETTER MD
Provider Business Mailing Address
First Line : 6938 MEDICAL VIEW LN
Second Line :
City : ZEPHYRHILLS
State : FL
Zip : 33542-6602
Country : US
Telephone Number : 813-780-2550
Fax Number : 813-780-3012
Provider Business Practice Location Address
First Line : 6938 MEDICAL VIEW LN
Second Line :
City : ZEPHYRHILLS
State : FL
Zip : 33542-6602
Country : US
Telephone Number : 813-780-2550
Fax Number : 813-780-3012
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2008
Last Update Date : 11/09/2023

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