Provider Demographics
NPI:1861191595
Name:KOPTOWSKY, JOSEPH ISRAEL (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ISRAEL
Last Name:KOPTOWSKY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14125 S.W. 46 TERRACE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175
Mailing Address - Country:US
Mailing Address - Phone:305-905-2582
Mailing Address - Fax:
Practice Address - Street 1:9408 S.W. 87 AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:305-274-8955
Practice Address - Fax:305-200-3783
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS11498183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist