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General NPI Number Information
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NPI Number | 1114803996
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Entity Type | Organization
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Legal Business Name | CQC MIAMI
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Dates
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Enumeration Date | 08/15/2025
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 4101 NW 3RD CT STE 15
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City | PLANTATION
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State | FL
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Zip | 33317-2830
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Country | US
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Telephone | 786-207-4788
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Fax | 954-568-8630
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Provider Business Mailing Address
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Address Line | PO BOX 91
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City | HALLANDALE BEACH
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State | FL
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Zip | 33008-0091
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. SIDNEY COUPET
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Credential | DO, MPH, MHS
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Telephone | 786-207-4788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number |
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License Number State |
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