Provider Demographics
NPI:1417284720
Name:COPTY, ANTOINE EMIL (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTOINE
Middle Name:EMIL
Last Name:COPTY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 BRICKELL AVE STE D301
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2939
Mailing Address - Country:US
Mailing Address - Phone:713-724-8353
Mailing Address - Fax:
Practice Address - Street 1:1925 BRICKELL AVE STE D301
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33129-2939
Practice Address - Country:US
Practice Address - Phone:713-724-8353
Practice Address - Fax:844-487-3937
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY56007503152W00000X
FLOPC4627152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0318640Medicaid
NY0318640Medicaid
NYG400022686Medicare PIN