Provider Demographics
NPI:1245722941
Name:GOPIE, STEPHANIE L (MD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:L
Last Name:GOPIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 NW 15TH ST STE 201A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-1342
Mailing Address - Country:US
Mailing Address - Phone:561-961-0680
Mailing Address - Fax:561-766-4998
Practice Address - Street 1:1050 NW 15TH ST STE 201A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-1342
Practice Address - Country:US
Practice Address - Phone:561-961-0680
Practice Address - Fax:561-766-4998
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-30
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN26264208600000X
FLME164908207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty