Provider Demographics
NPI:1497738900
Name:KOPELMAN, JEFF D (DPM)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:D
Last Name:KOPELMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 4TH STREET NORTH
Mailing Address - Street 2:ALL FLORIDA ORTHOPAEDIC ASSOCIATES
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-3802
Mailing Address - Country:US
Mailing Address - Phone:727-527-5272
Mailing Address - Fax:727-522-7412
Practice Address - Street 1:4423 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-8232
Practice Address - Country:US
Practice Address - Phone:727-321-4040
Practice Address - Fax:727-522-7412
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-29
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO0002119213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65149OtherBCBS
FL202493OtherAMERIGROUP
FL390062200Medicaid
FL480013205OtherRETIRED RAILROAD MEDICARE
FL480013205OtherRETIRED RAILROAD MEDICARE
FL390062200Medicaid