Organization
CHRISTIAN L KOPPEL MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIAN L KOPPEL M.D. (OWNER)
(904) 398-3356
Entity
Organization
Contact information
Practice address
820 PRUDENTIAL DR, SUITE 606, JACKSONVILLE, FL 32207-8210
(904) 398-3356
(904) 398-5397
Mailing address
820 PRUDENTIAL DR, SUITE 606, JACKSONVILLE, FL 32207-8210
(904) 398-3356
(904) 398-5397
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME43414
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00318062A
—
GA
05
—
040168400
—
FL
01
—
15878
FLORIDA BLUE CROSS BLUE SHIELD
—
Enumeration date
02/06/2012
Last updated
02/06/2012
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