Individual
EVANGELIA FOTOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2222 S HARBOR CITY BLVD, SUITE 430, MELBOURNE, FL 32901-5594
(321) 541-1777
(321) 725-5504
Mailing address
2222 S HARBOR CITY BLVD, STE 440, MELBOURNE, FL 32901-5591
(321) 541-1744
(321) 725-4183
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
L.3075R
AL
207Q00000X
Family Medicine Physician
Primary
ME112559
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005580100
—
FL
Enumeration date
12/17/2009
Last updated
01/04/2017
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