Provider Demographics
NPI:1760444699
Name:HOPPE, STANISLAW (MD)
Entity Type:Individual
Prefix:
First Name:STANISLAW
Middle Name:
Last Name:HOPPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8106 LAKE SERENE DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32836-5019
Mailing Address - Country:US
Mailing Address - Phone:407-345-0655
Mailing Address - Fax:
Practice Address - Street 1:2555 S KIRKMAN RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-2346
Practice Address - Country:US
Practice Address - Phone:407-362-2030
Practice Address - Fax:407-362-2040
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME69043207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL31888AMedicare ID - Type Unspecified
FL31888UMedicare PIN
F70722Medicare UPIN