Healthcare Provider Details

I. General information

NPI: 1407076953
Provider Name (Legal Business Name): DARRIN CUPO DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 N UNIVERSITY DRIVE SUITE B
CORAL SPRINGS FL
33071
US

IV. Provider business mailing address

1670 N UNIVERSITY DRIVE SUITE B
CORAL SPRINGS FL
33071
US

V. Phone/Fax

Practice location:
  • Phone: 954-346-8108
  • Fax: 954-346-0057
Mailing address:
  • Phone: 954-346-8108
  • Fax: 954-346-0057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number13006
License Number StateFL

VIII. Authorized Official

Name: DARRIN CUPO
Title or Position: ORTHODONTIST
Credential: DMD
Phone: 954-346-8108