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NPI Code Detail

MEDICARE: DONALD CUPP MSW

MEDICARE:   DONALD  CUPP  MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1811362429
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD CUPP MSW
Provider Business Mailing Address
First Line : 1485 S SEMORAN BLVD., SUITE 1448
Second Line :
City : WINTER PARK
State : FL
Zip : 32792
Country : US
Telephone Number : 321-397-3000
Fax Number :
Provider Business Practice Location Address
First Line : 20162 CORTEZ BLVD
Second Line :
City : BROOKSVILLE
State : FL
Zip : 34601-3832
Country : US
Telephone Number : 352-584-4076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2015
Last Update Date : 03/15/2026

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