Provider Demographics
NPI:1932487279
Name:BOPP, CHRISTOPHER J (CRNA)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:J
Last Name:BOPP
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2441 STAVER STREET
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33980-5914
Mailing Address - Country:US
Mailing Address - Phone:941-875-9363
Mailing Address - Fax:941-875-9363
Practice Address - Street 1:2154 DUCK SLOUGH BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-5073
Practice Address - Country:US
Practice Address - Phone:727-937-6020
Practice Address - Fax:727-934-1250
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2012-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9234675367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered