Provider Demographics
NPI:1407862196
Name:POPKIN, CATHERINE D (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:D
Last Name:POPKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N FLAMINGO RD
Mailing Address - Street 2:SUITE 309
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33028-1015
Mailing Address - Country:US
Mailing Address - Phone:954-436-1400
Mailing Address - Fax:954-436-1459
Practice Address - Street 1:601 N FLAMINGO RD
Practice Address - Street 2:SUITE 309
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33028-1015
Practice Address - Country:US
Practice Address - Phone:954-436-1400
Practice Address - Fax:954-436-1459
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51764207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E88430Medicare UPIN
FL12281Medicare ID - Type Unspecified