Individual
DR. GOPAL R KORUPOLU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12204 CORTEZ BLVD, BROOKSVILLE, FL 34613-2630
(352) 799-3449
(352) 799-3214
Mailing address
PO BOX 15781, BROOKSVILLE, FL 34604-0124
(352) 799-3449
(352) 799-3214
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
ME0070951
FL
208D00000X
General Practice Physician
Primary
ME0070951
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007336200
—
FL
Enumeration date
06/18/2006
Last updated
01/06/2015
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