| Kopa LLC | |
|
5900 Lake Ellenor Dr Ste 700 Orlando FL 32809-4643 | |
| (407) 352-2542 | |
| (844) 556-8650 |
| Full Name | Kopa LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 5900 Lake Ellenor Dr Ste 700, Orlando, Florida |
| Authorized Official Name and Position | Kimberly L Biegasiewicz (PRESIDENT) |
| Authorized Official Contact | 4072160101 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kopa LLC 5900 Lake Ellenor Dr Ste 700 Orlando FL 32809-4643 Ph: (407) 352-2542 | Kopa LLC 5900 Lake Ellenor Dr Ste 700 Orlando FL 32809-4643 Ph: (407) 352-2542 |
| NPI Number | 1417021114 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 12/22/2023 |
| Certification Date | 10/02/2023 |
| Medicare PECOS PAC ID | 5193774461 |
|---|---|
| Medicare Enrollment ID | O20050113001021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417021114 | NPI | - | NPPES |
| 94707 | Other | FL | BLUE CROSS BLUE SHEILD |
| 107434200 | Medicaid | FL | |
| HCC10648 | Other | FL | AHCA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (NU) | Primary |
| 208M00000X | Hospitalist | (NU) | Secondary |
| Provider Name | David F Romero Fischmann |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700826807 PECOS PAC ID: 3971577461 Enrollment ID: I20040820000898 |
| Provider Name | Kauser Akhter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1336111848 PECOS PAC ID: 6103877717 Enrollment ID: I20050201000524 |
| Provider Name | Dorothy Lasky |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366551269 PECOS PAC ID: 2769415959 Enrollment ID: I20050917000248 |
| Provider Name | Gregory P. Samano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356317101 PECOS PAC ID: 3678587714 Enrollment ID: I20060213000199 |
| Provider Name | Keron Alicia Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215007125 PECOS PAC ID: 4284725565 Enrollment ID: I20070801000657 |
| Provider Name | Cecilia Bato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164617387 PECOS PAC ID: 6507932233 Enrollment ID: I20080904000107 |
| Provider Name | Christa M Jeavons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245438068 PECOS PAC ID: 7719059161 Enrollment ID: I20090604000409 |
| Provider Name | Kacian Simone Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508029141 PECOS PAC ID: 2466590492 Enrollment ID: I20101020001257 |
| Provider Name | Shawn Chopra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518122290 PECOS PAC ID: 1456523042 Enrollment ID: I20111003000626 |
| Provider Name | Maximo J Fernandez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215119185 PECOS PAC ID: 0345413126 Enrollment ID: I20111024000709 |
| Provider Name | Matthew M Schroeder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063730687 PECOS PAC ID: 6901033125 Enrollment ID: I20131216000374 |
| Provider Name | Rory C Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043522915 PECOS PAC ID: 9638307564 Enrollment ID: I20150728003524 |
| Provider Name | Efren Gonzalo Cesar Balbin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124492129 PECOS PAC ID: 8325338254 Enrollment ID: I20160606002367 |
| Provider Name | Bamidele O Olupona |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1548502867 PECOS PAC ID: 8224322409 Enrollment ID: I20160810002841 |
| Provider Name | Jesse Michael Fazzingo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316487218 PECOS PAC ID: 8426326893 Enrollment ID: I20170608001064 |
| Provider Name | Melanie Serafine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215473228 PECOS PAC ID: 5597033340 Enrollment ID: I20170620000539 |
| Provider Name | Jasmine M Cruz |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1376938183 PECOS PAC ID: 3476818873 Enrollment ID: I20180606002490 |
| Provider Name | Daniel James Allen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548755408 PECOS PAC ID: 7719237924 Enrollment ID: I20180910002719 |
| Provider Name | Jordan R Roberson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669965000 PECOS PAC ID: 1557607280 Enrollment ID: I20190116002550 |
| Provider Name | Courtney Grace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205399151 PECOS PAC ID: 3274864350 Enrollment ID: I20191004001229 |
| Provider Name | Vincenzo Scotto D Antuono |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811962855 PECOS PAC ID: 7618963513 Enrollment ID: I20200325000049 |
| Provider Name | Lynsey Materni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003457888 PECOS PAC ID: 1850722414 Enrollment ID: I20200514001749 |
| Provider Name | Faith Daza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902430473 PECOS PAC ID: 1850710575 Enrollment ID: I20200930000962 |
| Provider Name | Renee Rebert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043785074 PECOS PAC ID: 4587905849 Enrollment ID: I20201008001474 |
| Provider Name | Rusheena Bartlett |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1427581123 PECOS PAC ID: 8820365372 Enrollment ID: I20201118000728 |
| Provider Name | Lobaba Habach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689292401 PECOS PAC ID: 5395145247 Enrollment ID: I20210614003128 |
| Provider Name | Shana Mccloud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679150338 PECOS PAC ID: 5799188520 Enrollment ID: I20210730000996 |
| Provider Name | Kristy Vandergriff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699298372 PECOS PAC ID: 9537432133 Enrollment ID: I20211229000683 |
| Provider Name | Isolyn Mahaliah Housen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750994570 PECOS PAC ID: 0941688386 Enrollment ID: I20220526000018 |
| Provider Name | Jimmy Dorival |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114372596 PECOS PAC ID: 2062893597 Enrollment ID: I20220715000026 |
| Provider Name | Carly Nicole Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871239723 PECOS PAC ID: 9830572635 Enrollment ID: I20220811001079 |
| Provider Name | Nancy Dorcelus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184289506 PECOS PAC ID: 1850776253 Enrollment ID: I20220921002858 |
| Provider Name | Yacob Yousif Habboush |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750842142 PECOS PAC ID: 7719214626 Enrollment ID: I20221003001135 |
| Provider Name | Jasmine S Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629799101 PECOS PAC ID: 4587040167 Enrollment ID: I20221005001234 |
| Provider Name | James Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194499822 PECOS PAC ID: 2961808142 Enrollment ID: I20230105001872 |
| Provider Name | Jessica Santana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265160121 PECOS PAC ID: 2567821192 Enrollment ID: I20230629003047 |
| Provider Name | Kayann Namesha Barrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588350185 PECOS PAC ID: 1456707694 Enrollment ID: I20231025000981 |
| Provider Name | Virginia Eve Flores |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356033229 PECOS PAC ID: 2769831957 Enrollment ID: I20231213002229 |
| Provider Name | Omar F Awwad |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265211692 PECOS PAC ID: 0042653883 Enrollment ID: I20240208000966 |
| Provider Name | Keila Nicole Pimentel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801571062 PECOS PAC ID: 2668914656 Enrollment ID: I20240605003035 |
| Provider Name | Caylee Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245085489 PECOS PAC ID: 4587100284 Enrollment ID: I20240718000457 |
| Provider Name | Magali Rezende De Carvalho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396592283 PECOS PAC ID: 9739614926 Enrollment ID: I20241125002848 |
| Provider Name | Ikola Baccas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649964693 PECOS PAC ID: 3476081373 Enrollment ID: I20250106002325 |
| Provider Name | Bryan Gonzalez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104688563 PECOS PAC ID: 9537661871 Enrollment ID: I20250905004047 |
| Provider Name | Jocelynn Au |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518846328 PECOS PAC ID: 2365947025 Enrollment ID: I20250924001230 |
| Provider Name | Davidson Antenor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720527815 PECOS PAC ID: 5890284269 Enrollment ID: I20251028000312 |
| Provider Name | Jarrett Hayles-patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902542152 PECOS PAC ID: 3173905064 Enrollment ID: I20251109000053 |
| Provider Name | Lisa Lynn Durkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295092906 PECOS PAC ID: 5294096517 Enrollment ID: I20251205000658 |
| Provider Name | Carame Cameau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063294106 PECOS PAC ID: 6204318900 Enrollment ID: I20260303002230 |
Instant Medical Care LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7300 Sandlake Commons Blvd Ste 227, Orlando, FL 32819 Phone: 407-426-4099 Fax: 407-809-5243 |
Evoyent Health Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 S Orange Ave Ste 900, Orlando, FL 32801 Phone: 321-282-1999 |
Orlando Family Physicians, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 W Colonial Dr Ste 303, Orlando, FL 32804 Phone: 321-332-6947 Fax: 407-286-4515 |
The Concierge Doctors Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8976 Conroy Windermere Rd, Orlando, FL 32835 Phone: 321-848-4986 |
Spartan Medical Men's Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9145 Narcoossee Rd Ste A102, Orlando, FL 32827 Phone: 407-703-6020 |
Abid Rasool, M.D., P.A. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4501 S Semoran Blvd, Orlando, FL 32822 Phone: 407-380-1428 |