Healthcare Provider Details

I. General information

NPI: 1366422933
Provider Name (Legal Business Name): JOAN DIANE COUPLAND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 TUSKAWILLA RD STE 221
WINTER SPRINGS FL
32708-5289
US

IV. Provider business mailing address

1425 TUSKAWILLA RD STE 221
WINTER SPRINGS FL
32708-5289
US

V. Phone/Fax

Practice location:
  • Phone: 407-775-5315
  • Fax: 407-287-6835
Mailing address:
  • Phone: 407-775-5315
  • Fax: 407-287-6835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME79870
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: