Provider Demographics
NPI:1184625162
Name:VOPAL, JAMES J (DDS, MD, FACS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:VOPAL
Suffix:
Gender:M
Credentials:DDS, MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SE OSCEOLA ST
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2431
Mailing Address - Country:US
Mailing Address - Phone:772-220-4050
Mailing Address - Fax:772-220-0502
Practice Address - Street 1:801 SE OSCEOLA ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2431
Practice Address - Country:US
Practice Address - Phone:772-220-4050
Practice Address - Fax:772-220-0502
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0037442208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL95885Medicare ID - Type Unspecified
FLD82642Medicare UPIN