Christian L Koppel Md Pa
Anesthesiology Physician in Jacksonville, FL(View on Map)
Legal Business Name
Christian L Koppel Md Pa
NPI Number
1457623514
NPI Type
Organization
Enumeration Date
02/06/2012
Specialties
(Taxonomies)Licenses
State
Florida
License Number
ME43414
Contact
Information
Purpose
Mailing
Location
Address
820 PRUDENTIAL DR
820 PRUDENTIAL DR
City
Jacksonville
Jacksonville
State
FL
FL
Postal Code
32207-8210
32207-8210
Country
US
US
Telephone Number
(904) 398-3356
(904) 398-3356
Authorized Official
Name
Christian Koppel
Title or Position
OWNER
Telephone Number
(904) 398-3356
Identifiers
Identifier
15878
00318062A
040168400
Identifier State
Unknown
GA
FL
Identifier Issuer
FLORIDA BLUE CROSS BLUE SHIELD
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 02/06/2012
Provider Address
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