Provider Demographics
NPI:1013097625
Name:HELOPOULOS, J CHRIS (PA-C)
Entity Type:Individual
Prefix:
First Name:J
Middle Name:CHRIS
Last Name:HELOPOULOS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2410
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33779-2410
Mailing Address - Country:US
Mailing Address - Phone:727-581-8706
Mailing Address - Fax:727-588-2447
Practice Address - Street 1:148 13TH ST SW
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3127
Practice Address - Country:US
Practice Address - Phone:727-581-8706
Practice Address - Fax:727-588-2447
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2827363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL292670900Medicaid
Q75645Medicare UPIN
FL292670900Medicaid