Individual
ROBERT WALTER KOPP II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
39 BARKLEY CIR, FORT MYERS, FL 33907-7531
(239) 936-1616
(239) 936-0837
Mailing address
2160 COLONIAL BLVD, FORT MYERS, FL 33907-1410
(239) 931-7342
(239) 931-7385
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME131112
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020773400
—
FL
01
—
403947
AVMED
FL
01
—
4186442
AETNA
FL
01
—
8930791
CIGNA
FL
01
—
ITLYM
BCBS
FL
01
—
IZ699Z
MEDICARE
FL
01
—
P1056555
FREEDOM
FL
01
—
P988125
OPTIMUM
FL
01
—
QMP000005329965
MOLINA
FL
Enumeration date
05/07/2012
Last updated
07/21/2022
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