Provider Demographics
NPI:1164505137
Name:COUPET, EDOUARD (MD)
Entity Type:Individual
Prefix:DR
First Name:EDOUARD
Middle Name:
Last Name:COUPET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16890 SW 49TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027
Mailing Address - Country:US
Mailing Address - Phone:954-600-3744
Mailing Address - Fax:954-534-9930
Practice Address - Street 1:1951 SW 172ND AVENUE SUITE 200
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33029
Practice Address - Country:US
Practice Address - Phone:954-600-3744
Practice Address - Fax:954-534-9930
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME103224207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003541500Medicaid