Basic Information
| Provider Information | |||||||||
| NPI: | 1932487279 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOPP | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2441 STAVER STREET | ||||||||
| Address2: | |||||||||
| City: | PORT CHARLOTTE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339805914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9418759363 | ||||||||
| FaxNumber: | 9418759363 | ||||||||
| Practice Location | |||||||||
| Address1: | 2154 DUCK SLOUGH BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | TRINITY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346555073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7279376020 | ||||||||
| FaxNumber: | 7279341250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2011 | ||||||||
| LastUpdateDate: | 02/15/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | ARNP9234675 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.