Provider Demographics
NPI:1720402225
Name:GOPINATH SUNIL MD PA
Entity type:Organization
Organization Name:GOPINATH SUNIL MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GOPINATH
Authorized Official - Middle Name:S
Authorized Official - Last Name:SUNIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-325-1111
Mailing Address - Street 1:11181 HEALTH PARK BLVD STE 3050
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-5744
Mailing Address - Country:US
Mailing Address - Phone:321-325-1111
Mailing Address - Fax:239-249-6799
Practice Address - Street 1:11181 HEALTH PARK BLVD STE 3050
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-5744
Practice Address - Country:US
Practice Address - Phone:321-325-1111
Practice Address - Fax:239-249-6799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-05
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83396207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME83396OtherFL LICENSE ME83396
FLME83396OtherFL LICENSE ME83396