Provider Demographics
NPI:1619923323
Name:KOOP, HERMES O (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMES
Middle Name:O
Last Name:KOOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:599 9TH ST N
Mailing Address - Street 2:STE 307
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5623
Mailing Address - Country:US
Mailing Address - Phone:239-325-4801
Mailing Address - Fax:239-325-4800
Practice Address - Street 1:599 9TH ST N
Practice Address - Street 2:STE 307
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5623
Practice Address - Country:US
Practice Address - Phone:239-325-4801
Practice Address - Fax:239-325-4800
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0061948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0480220OtherUNITED HEALTH
FL14810OtherBLUE SHIELD
FL370583800Medicaid
FL40916DOtherBLUE CROSS
FL4467476OtherAETNA
FL276779OtherONE HEALTH PLAN
FL276779OtherONE HEALTH PLAN
FLB24072Medicare UPIN