10D2030786 CLIA NUMBER - PAUL M POPPER MD PA

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Laboratory Demographics

CLIA Number: 10D2030786

Facility Name: PAUL M POPPER MD PA

Facility Address:
21229 OLEAN BLVD UNIT D
PORT CHARLOTTE, FL
ZIP 33952
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Facility Phone Number: 941 625-6223

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124045216

Taxonomy: 207RC0000X - Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

CLIA Record

Field Name	Field Value
CLIA Number	10D2030786
LAB Type	Physician Office
Facility Name	PAUL M POPPER MD PA
Street	21229 OLEAN BLVD UNIT D
City	PORT CHARLOTTE
State	FL
ZIP	33952
Phone	941 625-6223
CertificateType	4
CertificateEffectiveDate	10/5/2023
CertificateExpirationDate	10/4/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024