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NPI Code Detail

MEDICARE: DR. DEAN THEOPHILOPOULOS M.D.

MEDICARE: DR. DEAN THEOPHILOPOULOS 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
12080N0001XNeonatal-Perinatal Medicine PhysicianME0075663FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
143817OTHERFLBC/BS NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528014545
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEAN THEOPHILOPOULOS M.D.
Provider Business Mailing Address
First Line : 150 N SPRING BLVD
Second Line :
City : TARPON SPRINGS
State : FL
Zip : 34689-3247
Country : US
Telephone Number : 727-271-5650
Fax Number : 727-946-9062
Provider Business Practice Location Address
First Line : 1700 S TAMIAMI TRL
Second Line :
City : SARASOTA
State : FL
Zip : 34239-3555
Country : US
Telephone Number : 941-917-5525
Fax Number : 941-917-1689
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 02/16/2023

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