Provider Demographics
NPI:1861438343
Name:HOPKINS, STANLEY C (MD)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:C
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2419 S SEACREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-6701
Mailing Address - Country:US
Mailing Address - Phone:561-732-6901
Mailing Address - Fax:
Practice Address - Street 1:2419 S SEACREST BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-6701
Practice Address - Country:US
Practice Address - Phone:561-732-6901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME40990208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL067009000Medicaid
FL30526OtherBLUE CROSS BLUE SHIELD
FLE11933Medicare UPIN
FL30526Medicare ID - Type Unspecified