Provider Demographics
NPI:1043315203
Name:KUPRACZ, BETTY (MD)
Entity type:Individual
Prefix:DR
First Name:BETTY
Middle Name:
Last Name:KUPRACZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6376 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3908
Mailing Address - Country:US
Mailing Address - Phone:239-239-4221
Mailing Address - Fax:239-348-4433
Practice Address - Street 1:6376 PINE RIDGE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3908
Practice Address - Country:US
Practice Address - Phone:239-239-4221
Practice Address - Fax:239-348-4433
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME147658207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTI34434Medicare UPIN
CT110009580Medicare ID - Type Unspecified