Provider Demographics
NPI:1497158976
Name:POPA, OFELIA
Entity type:Individual
Prefix:MRS
First Name:OFELIA
Middle Name:
Last Name:POPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:OFELIA
Other - Middle Name:
Other - Last Name:TIPU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8886 WHITE IBIS WAY
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-3623
Mailing Address - Country:US
Mailing Address - Phone:213-509-7277
Mailing Address - Fax:
Practice Address - Street 1:8886 WHITE IBIS WAY
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-3623
Practice Address - Country:US
Practice Address - Phone:213-509-7277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1131482103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst