Basic Information
| Provider Information | |||||||||
| NPI: | 1922716984 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOPA ENDOCRINOLOGY PLLC | ||||||||
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| Address1: | 209 NE 95TH ST STE 4 | ||||||||
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| City: | MIAMI SHORES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331382745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056286117 | ||||||||
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| Practice Location | |||||||||
| Address1: | 209 NE 95TH ST STE 4 | ||||||||
| Address2: | |||||||||
| City: | MIAMI SHORES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331382745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056286117 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2022 | ||||||||
| LastUpdateDate: | 11/09/2022 | ||||||||
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| AuthorizedOfficialLastName: | APAZA-CONCHA | ||||||||
| AuthorizedOfficialFirstName: | ANA | ||||||||
| AuthorizedOfficialMiddleName: | CECILIA | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3056286117 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 11/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | EZ354Z | 01 | FL | INTERNAL MEDICINE - ENDOCRINOLOGY, DIABETES & METABOLISM | OTHER |