Provider Demographics
NPI:1013135409
Name:GOPIE, KIRK (OD)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:
Last Name:GOPIE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33501 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:FLORIDA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33034-5628
Mailing Address - Country:US
Mailing Address - Phone:786-243-1222
Mailing Address - Fax:305-242-4183
Practice Address - Street 1:33501 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FLORIDA CITY
Practice Address - State:FL
Practice Address - Zip Code:33034-5628
Practice Address - Country:US
Practice Address - Phone:786-243-1222
Practice Address - Fax:305-242-4183
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC3234152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001277900Medicaid