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Individual

DR. USA KOPSOMBUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
13535 NEMOURS PKWY, ORLANDO, FL 32827-7402
(407) 567-4000
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
ME132865
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
022356900
FL
Enumeration date
04/28/2014
Last updated
03/18/2019
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