Individual
RICHARD MARTIN COPPOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1208 N UNIVERSITY DR, PLANTATION, FL 33322-4724
(954) 583-0412
(954) 584-3906
Mailing address
6101 BLUE LAGOON DR STE 400, MIAMI, FL 33126-2051
(305) 500-2000
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
OS003596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
592228969
TAX ID
FL
Enumeration date
07/18/2006
Last updated
08/28/2020
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