Provider Demographics
NPI:1093894461
Name:APOSTOLOPOULOS, NEOPHETOS VASILIOS (MD)
Entity Type:Individual
Prefix:
First Name:NEOPHETOS
Middle Name:VASILIOS
Last Name:APOSTOLOPOULOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 NW 15TH ST
Mailing Address - Street 2:SUITE 107A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1375
Mailing Address - Country:US
Mailing Address - Phone:561-353-2061
Mailing Address - Fax:561-367-0147
Practice Address - Street 1:1050 NW 15TH STREET
Practice Address - Street 2:SUITE 107A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2346
Practice Address - Country:US
Practice Address - Phone:561-353-2061
Practice Address - Fax:561-367-0147
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93829207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI43307Medicare UPIN
FLU6168ZMedicare ID - Type Unspecified