1225110786 NPI number — JAMES J VOPAL MD,PA

Table of content: RENEE T CLEMENT M.ED (NPI 1376294058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225110786 NPI number — JAMES J VOPAL MD,PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES J VOPAL MD,PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225110786
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 SE OSCEOLA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STUART
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34994-2431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
772-220-4050
Provider Business Mailing Address Fax Number:
772-220-0502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 SE OSCEOLA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STUART
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34994-2431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
772-220-4050
Provider Business Practice Location Address Fax Number:
772-220-0502
Provider Enumeration Date:
10/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
VOPAL
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
772-220-4050

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  ME37442 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 4008234 . This is a "DR VOPAL AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6385719003 . This is a "DR VOPAL CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: ME37442 . This is a "DR VOPAL STATE LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: ME97068 . This is a "DR SANDERSON STATE LICEN" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1184625162 . This is a "DR VOPAL NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1689768491 . This is a "DR SANDERSON NPI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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