DR. GEORGE C KOPPUZHA (NPI# 1982648101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982648101 |
| Entity Type | Individual |
| Full Name | DR. GEORGE C KOPPUZHA |
| Credential | M.D. |
| Practice Address |
2091 Tamiami Trl Ste B Port Charlotte FL 33948-2112 |
| Practice Telephone | 9416259494 |
| Practice Fax Number | 9417438562 |
| Mailing Telephone | 9416242787 |
| Mailing Fax Number | 8552113727 |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2017-03-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | ME0074583 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 255240000 | 05 | |
| WELLCARE | 279368 | 01 | |
| FL | BLUE CROSS & BLUE SHIELD | 44529 | 01 |
| FL | MEDICARE GROUP | AK532 | 01 |
| Street Address |
2091 TAMIAMI TRL STE B |
| City | PORT CHARLOTTE |
| State | FL |
| Zip Code | 33948-2112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053304774 | Tanweer A Memon | Internal Medicine | 2091 Tamiami Trl, Port Charlotte, FL 33948-2112 | 2005-08-28 |
| 1427457936 | Melissa Wilson | Nurse Practitioner | 2091 Tamiami Trl, Port Charlotte, FL 33948-2112 | 2014-08-20 |
| 1841216421 | Tanweer Memon Md Pa | Internal Medicine | 2091 Tamiami Trl, Port Charlotte, FL 33948-2112 | 2006-07-15 |
| 1851320923 | Charlotte Internal Medicine Associates Pa | Internal Medicine | 2091 Tamiami Trl, Port Charlotte, FL 33948-2112 | 2006-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750926705 | Kelli Sue Boley | Pharmacist | 19100 Murdock Circle, Port Charlotte, FL 33948 | 2019-11-14 |
| 1013469709 | Daria Erdmann | Counselor | 1720 El Jobean Rd Unit 200, Port Charlotte, FL 33948 | 2016-10-27 |
| 1699172270 | Best Hearing Aid Solutions, Inc | Hearing Instrument Specialist | 1931 Tamiami Tr #7, Port Charlotte, FL 33948 | 2014-11-26 |
| 1811331283 | Nic 4 Village Place Leasing LLC | Assisted Living Facility | 18400 Cochran Blvd., Port Charlotte, FL 33948 | 2013-04-29 |
| 1215277686 | Sarah Anne Baker | Physical Therapy Assistant | 18480 Corcoran Blvd., Port Charlotte, FL 33948 | 2013-02-22 |
| 1023362373 | Clement Gustavous Smith | Adult Companion | 3081 Jody Street, Port Charlotte, FL 33948 | 2012-11-07 |
| 1306106232 | Charlotte County Family Ymca, Inc | Physical Therapist | 19333 Quesada Ave, Port Charlotte, FL 33948 | 2012-05-25 |
| 1043529738 | Dynamic Dental Health Associates of Florida, Pa | Dentist | 3280 Tamiami Trail # 56, Port Charlotte, FL 33948 | 2010-09-29 |
| 1508099847 | Victoria Lynn Wagner | Hearing Instrument Specialist | 1441 Tamiami Trail, #491, Port Charlotte, FL 33948 | 2009-09-03 |
| 1902060601 | Domingo E Galliano Jr Pa | Surgery | 18308 Murdock Circle 108, Domingo E Galliano Jr Md Pa, Port Charlotte, FL 33948 | 2008-07-11 |
| Find all providers in zip 33948 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639613300 | Kalyani Regeti | Internal Medicine | 3611 Tamiami Trl Ste B, Port Charlotte, FL 33952-5508 | 2016-12-14 |
| 1740601731 | Peace of Mind Internal Medicine Pllc Jennifer A Cooke Sole Mbr | Internal Medicine | 1675 Tamiami Trl, Ste 5, Port Charlotte, FL 33948-1042 | 2013-12-18 |
| 1912291725 | Sanjeev Zutshi Pa | Internal Medicine | 3390 Tamiami Trl Ste 105, Port Charlotte, FL 33952-8161 | 2011-06-09 |
| 1033354873 | Chitradeep De | Internal Medicine | 2852 Tamiami Trl Ste 4, Port Charlotte, FL 33952-5100 | 2008-12-09 |
| 1083864474 | Mario E Carbonell Md Pa | Internal Medicine | 17912 Toldeo Blade Blvd Ste A, Port Charlotte, FL 33948-1042 | 2008-09-23 |
| 1902087810 | Juan C Torres-urrutia Md Pa | Internal Medicine | 21202 Olean Blvd Ste C1, Port Charlotte, FL 33952-6725 | 2007-11-19 |
| 1659551356 | Aneley Yegezu Hundae | Internal Medicine | 3161 Harbor Blvd Ste A, Port Charlotte, FL 33952-6754 | 2007-11-09 |
| 1336338870 | Rias Ali, Md, Pa | Internal Medicine | 23362 Duchess Ave, Port Charlotte, FL 33954-2500 | 2007-10-22 |
| 1235321639 | Brian D Ardel Md Pa | Internal Medicine | 3417 Tamiami Trl Ste D, Port Charlotte, FL 33952-8158 | 2007-08-10 |
| 1649489014 | Arthur R Ballard II | Internal Medicine | 23081 Harborview Rd, Port Charlotte, FL 33980-2153 | 2007-05-22 |
| Find all providers in PORT CHARLOTTE | ||||
| City | PORT CHARLOTTE |
| Zip Code | 33948 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.