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Organization

KOPA LLC

Active
Other names
KOPA PA, Coast To Coast Physicians Alliance, Sand Lake Hospitalists,
Organization subpart
No

Provider details

NPI number
Authorized official
KIMBERLY L BIEGASIEWICZ (PRESIDENT)
(407) 216-0101
Entity
Organization

Contact information

Practice address
5900 LAKE ELLENOR DR STE 700, ORLANDO, FL 32809-4643
(407) 352-2542
(844) 556-8650
Mailing address
5900 LAKE ELLENOR DR STE 700, ORLANDO, FL 32809-4643
(407) 352-2542
(844) 556-8650

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107434200
FL
01
94707
BLUE CROSS BLUE SHEILD
FL
01
HCC10648
AHCA
FL
Enumeration date
11/17/2006
Last updated
12/22/2023
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