Provider Demographics
NPI:1003895871
Name:C. COUTS, MD PA
Entity Type:Organization
Organization Name:C. COUTS, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADULT PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:COUTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-323-6050
Mailing Address - Street 1:3261 U.S. HIGHWAY 27/441
Mailing Address - Street 2:SUITE C-2
Mailing Address - City:FRUITLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:34731
Mailing Address - Country:US
Mailing Address - Phone:352-323-6050
Mailing Address - Fax:352-323-0913
Practice Address - Street 1:3261 U.S. HIGHWAY 27/441
Practice Address - Street 2:SUITE C-2
Practice Address - City:FRUITLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:34731
Practice Address - Country:US
Practice Address - Phone:352-323-6050
Practice Address - Fax:352-323-0913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME923282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU5553ZMedicare ID - Type Unspecified
FLI39234Medicare UPIN