Provider Demographics
NPI:1659505782
Name:HOPMAN, RUSUDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RUSUDAN
Middle Name:
Last Name:HOPMAN
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 1:1840 MEASE DR STE 409
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-6606
Mailing Address - Country:US
Mailing Address - Phone:727-443-8450
Mailing Address - Fax:727-533-5911
Practice Address - Street 1:1840 MEASE DR STE 409
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6606
Practice Address - Country:US
Practice Address - Phone:727-443-8450
Practice Address - Fax:727-533-5911
Is Sole Proprietor?:No
Enumeration Date:2009-05-04
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122583207RH0003X
MO2012003323207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014812900Medicaid