Provider Demographics
NPI:1477557916
Name:CAMPOPIANO, DAVID J (ANP- BC, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:CAMPOPIANO
Suffix:
Gender:M
Credentials:ANP- BC, PMHNP-BC
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:CAMPOPIANO
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:ARNP BC
Mailing Address - Street 1:9307 CYPRESS BEND DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2553
Mailing Address - Country:US
Mailing Address - Phone:818-919-5508
Mailing Address - Fax:
Practice Address - Street 1:5331 PRIMROSE LAKE CIR STE 110
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3764
Practice Address - Country:US
Practice Address - Phone:813-501-2158
Practice Address - Fax:401-701-2444
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2020-12-16
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-22
Provider Licenses
StateLicense IDTaxonomies
FLARNP9329419363LA2200X
FLARNP93299419363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH23YP05399NH01OtherBCBS MEDICAL PROVIDER #
1700411360OtherGOUP NPI
FL23YP05399NH01OtherBCBS
NHP86114Medicare UPIN
NHUX2755Medicare PIN
1750543773OtherGROUP ' TYPE 2' NPI-SOLO PROVIDER/OWNER