MEDICARE: MRS. GEORGENA DOPYERA MSW

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1942005756
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GEORGENA DOPYERA MSW

Provider Business Mailing Address
First Line	:	2403 GRANDIFLORA BLVD
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32408-7078
Country	:	US
Telephone Number	:	713-444-5340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1220 JENKS AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-2441
Country	:	US
Telephone Number	:	888-772-4273
Fax Number	:

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

Provider Enumeration Date	:	02/17/2025
Last Update Date	:	02/17/2025

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