Provider Demographics
NPI:1639182819
Name:KONTOPOULOS, EFTICHIA V (MD)
Entity Type:Individual
Prefix:
First Name:EFTICHIA
Middle Name:V
Last Name:KONTOPOULOS
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 1:3850 BIRD RD
Mailing Address - Street 2:STE 401
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33146-1501
Mailing Address - Country:US
Mailing Address - Phone:720-753-3825
Mailing Address - Fax:786-780-2060
Practice Address - Street 1:3850 BIRD RD
Practice Address - Street 2:SUITE 401
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33146-1501
Practice Address - Country:US
Practice Address - Phone:720-453-3825
Practice Address - Fax:786-780-2060
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94744207V00000X, 207VM0101X
MO2016006833207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL274175000Medicaid
FL32010OtherBLUE CROSS BLUE SHIELD
FLI21685Medicare UPIN
FL274175000Medicaid