Provider Demographics
NPI:1679568596
Name:KOPP, CHRISTOPHER F (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:F
Last Name:KOPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2675 WINKLER AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9342
Mailing Address - Country:US
Mailing Address - Phone:877-856-3774
Mailing Address - Fax:239-599-2612
Practice Address - Street 1:12995 S CLEVELAND AVE STE 184
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-7703
Practice Address - Country:US
Practice Address - Phone:239-310-5305
Practice Address - Fax:239-310-5306
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1773681208800000X
FLME145295208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010093401OtherUNIVERA
NY005113202OtherCOMMUNITY BLUE
NY161511795OtherUNITED HEALTHCARE EMPIRE
NY0444OtherBLUE CROSS ROCHESTER
NY1904063OtherINDEPENDENT HEALTH
NY161511795OtherNOVA
NY161511795OtherNORTH AMERICAN
NY340013073OtherRAILROAD MEDICARE
NYP010177368OtherBLUE CHOICE
NY1099969OtherGHI
NYMD4405OtherPREFERRED CARE
NY01380643Medicaid
NY161511795OtherHUMANA
NY14360CMedicare ID - Type Unspecified
NY01380643Medicaid