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General NPI Number Information
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NPI Number | 1215476239
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Entity Type | Organization
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Legal Business Name | CQC HEALTHCARE PA
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Dates
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Enumeration Date | 02/23/2017
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1600 S FEDERAL HWY STE 550
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City | POMPANO BEACH
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State | FL
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Zip | 33062-7518
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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 | 814-449-3605
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIDNEY COUPET
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Credential | DO
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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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