Basic Information
| Provider Information | |||||||||
| NPI: | 1457951246 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOPPE | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | THOMAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM. D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 7451 BANNING WAY | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323098107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8508933294 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4021 LAGNIAPPE WAY | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323171201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8506567211 | ||||||||
| FaxNumber: | 8506569101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2020 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PS26830 | FL | Y | Pharmacy Service Providers | Pharmacist |
ID Information
| ID | Type | State | Issuer | Description | RPH017012 | 01 | GA | PHARMACIST STATE LICENSE NUMBER | OTHER | PS26830 | 01 | FL | PHARMACIST LICENSE NUMBER | OTHER |