Healthcare Provider Details

I. General information

NPI: 1255238200
Provider Name (Legal Business Name): VICTORIA R COPELAND CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2026
Last Update Date: 10/22/2026
Certification Date: 10/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 HICKORY ST
MELBOURNE FL
32901-3224
US

IV. Provider business mailing address

5875 PINE SAP AVE
GRANT VALKARIA FL
32949-8222
US

V. Phone/Fax

Practice location:
  • Phone: 321-434-7000
  • Fax:
Mailing address:
  • Phone: 425-442-0739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberCNA428412
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: