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General NPI Number Information
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NPI Number | 1356142178
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Entity Type | Individual
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Provider Name | NICOLE COUPET
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Gender | Female
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1971 SW 172ND AVE STE 3128
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City | MIRAMAR
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State | FL
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Zip | 33029-5623
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Country | US
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Telephone | 708-439-1426
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Fax |
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Provider Business Mailing Address
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Address Line | 5919 NW 56TH PL
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City | TAMARAC
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State | FL
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Zip | 33319-2313
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Country | US
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Telephone | 708-296-0636
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 11033041
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License Number State | FL
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