Provider Demographics
NPI:1144231218
Name:SARANTOPOULOS, KONSTANTINOS D (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:KONSTANTINOS
Middle Name:D
Last Name:SARANTOPOULOS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:CONSTANTINE
Other - Middle Name:D
Other - Last Name:SARANTOPOULOS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:1611 NW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1005
Mailing Address - Country:US
Mailing Address - Phone:305-243-8292
Mailing Address - Fax:305-243-3300
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-243-8292
Practice Address - Fax:305-243-3300
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI39634-020207LP2900X
FLME111077207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine