Healthcare Provider Details

I. General information

NPI: 1477753846
Provider Name (Legal Business Name): HAROLD MATTHEW COUCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MATTHEW HAROLD COUCH MD

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 7TH ST S STE 510
ST PETERSBURG FL
33701-4736
US

IV. Provider business mailing address

601 7TH ST S STE 510
ST PETERSBURG FL
33701-4736
US

V. Phone/Fax

Practice location:
  • Phone: 727-893-6480
  • Fax: 813-893-6481
Mailing address:
  • Phone: 727-893-6480
  • Fax: 813-893-6481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberBP1-0013121
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberBP1-0013121
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME102879
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: