Beena Koppuzha MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME0075143 Issued in FL

Legal business name

BEENA KOPPUZHA MD PA

Practice address

1141 S McCall Rd
Englewood, FL 34223-4229

Phone

(941) 475-6568

Fax

(941) 474-6706

NPI assigned

Jun 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Beena C Koppuzha, M.D.NPI 1710938402

Title

Physician

Phone

(941) 475-6568

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Beena C Koppuzha, M.D.

  • Internal Medicine Physician
  • Englewood, FL
  • NPI 1710938402
  Medicare reassignment NPD Authorized official
• George Cyriac Koppuzha, MD

  • Internal Medicine Physician
  • Port Charlotte, FL
  • NPI 1982648101
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279238400000",
    "number": "1194766550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 S MCCALL RD",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234229",
            "telephone_number": "941-475-6568",
            "fax_number": "941-474-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 S MCCALL RD",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342234229",
            "telephone_number": "941-475-6568",
            "fax_number": "941-474-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEENA KOPPUZHA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2010-07-16",
        "status": "A",
        "authorized_official_last_name": "KOPPUZHA",
        "authorized_official_first_name": "BEENA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "941-475-6568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME0075143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Browning Bassetti, D.O.
• Robert Francis Baumann, D.O.
• Edwin Alea Bautista, DPM
• Beacon Respiratory Services Inc
• Joshua A Beasley, PA-C
• Sara Beksi
• Ashley Bellant, APRN
• Bent Not Broken Counseling Services
• Sandie Marie Benton
• Lynn R Bernstein, PH.D

• Internal Medicine Physician in Englewood, FL
• Providers in Englewood, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.