Provider Demographics
NPI:1992722730
Name:KOPPIKAR, VINAYA S (MD)
Entity type:Individual
Prefix:
First Name:VINAYA
Middle Name:S
Last Name:KOPPIKAR
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 1:1065 NE 125TH ST
Mailing Address - Street 2:STE 300
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-5833
Mailing Address - Country:US
Mailing Address - Phone:888-852-6672
Mailing Address - Fax:305-891-4228
Practice Address - Street 1:1065 NE 125TH ST
Practice Address - Street 2:STE 206
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-5832
Practice Address - Country:US
Practice Address - Phone:305-891-0050
Practice Address - Fax:305-891-0497
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1512772084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
260039342OtherMEDICARE RAILROAD
WI32510700Medicaid
390808509OtherCT GENERAL
475887619OtherTRICARE
11766OtherDEAN HEALTH PLAN
390808509OtherCIGNA
90002361OtherWEA INS
390808509OtherWPS
39080850927OtherUNITY
1022445OtherPHYSICIANS PLUS
32510700OtherHIRSP
690004890OtherMEDICARE RAILROAD