Provider Demographics
NPI:1861660649
Name:YANKOPOLUS, KONSTANTINE KONSTANTINE (MD)
Entity Type:Individual
Prefix:DR
First Name:KONSTANTINE
Middle Name:KONSTANTINE
Last Name:YANKOPOLUS
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 1:3880 COLONIAL BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966-1062
Mailing Address - Country:US
Mailing Address - Phone:239-590-3883
Mailing Address - Fax:239-590-3884
Practice Address - Street 1:3880 COLONIAL BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966-1062
Practice Address - Country:US
Practice Address - Phone:239-590-3883
Practice Address - Fax:239-590-3884
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL022595207QA0505X
FLME22595208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine