Active NPI
Clint Copacia
- Pharmacist
- St Petersburg, FL
National Provider Identifier
1033960992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PS66387
- Practice address
- 1839 Central Ave
St Petersburg, FL 33713-8900 - Phone
- (727) 894-3001
- NPI assigned
- Mar 28, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS66387 | FL | Primary |
Addresses
Primary practice location
1839 Central Ave
St Petersburg, FL 33713-8900
Mailing address
4504 W Spruce St Apt 326
Tampa, FL 33607-5885
Phone (586) 823-1035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS66387 | FL | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1033960992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4504 W SPRUCE ST APT 326",
"city": "TAMPA",
"state": "FL",
"postal_code": "336075885",
"telephone_number": "586-823-1035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1839 CENTRAL AVE",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337138900",
"telephone_number": "727-894-3001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COPACIA",
"first_name": "CLINT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-03-28",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pharmacist",
"state": "FL",
"license": "PS66387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.