MIRIAN ANTELO COUCH (NPI# 1881938991) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881938991 |
Entity Type | Individual |
Full Name | MIRIAN ANTELO COUCH |
Other Name | MIRIAN ALICIAN ANTELO |
Credential | PA-C |
Practice Address |
6555 Chester Ave Ste 1 Jacksonville FL 32217 |
Mailing Address |
6555 Chester Ave Ste 1 Jacksonville FL 32217-2279 |
Practice Telephone | 9043096504 |
Practice Fax Number | 9045033577 |
Mailing Telephone | 9042658209 |
Mailing Fax Number | 9045033577 |
Enumeration Date | 2012-11-15 |
Last Update Date | 2018-08-10 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9106827 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
BCBS | Y0FR9 | 01 |
Street Address |
6555 CHESTER AVE STE 1 |
City | JACKSONVILLE |
State | FL |
Zip Code | 32217 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679513477 | David J Samara | Family Medicine | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2006-06-08 |
1366936361 | Leanne Derrico | Nurse Practitioner | 6555 Chester Ave Ste 1, Jacksonville, FL 32217 | 2018-06-22 |
1225529761 | Analyn Tesoro | Registered Nurse | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2018-05-21 |
1932604063 | Cynthia Priscilla Quinones | Nurse Practitioner | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2018-03-29 |
1790284602 | Megan Denee Borden | Nurse Practitioner | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2018-02-06 |
1083021679 | Jennifer Hoff | Nurse Practitioner | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2014-07-16 |
1336483015 | Molly M King | Physician Assistant | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2012-11-19 |
1801149984 | Andrea L Hoff | Physician Assistant | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2012-10-26 |
1780996892 | Nathan Thilges | Physician Assistant | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2010-07-06 |
1336214600 | Anne M Petersen | Physician Assistant | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2006-11-22 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336605005 | Mary Ellen Mccullough-list | Behavior Technician | 3437 Miruelo Circle North, Jacksonville, FL 32217 | 2019-02-18 |
1285131656 | Priority One Home Care LLC | In Home Supportive Care | 7500 Powers Ave Apt 198, Jacksonville, FL 32217 | 2018-04-11 |
1407361272 | Sharon Williams | Home Health | 8300 Plaza Gate Lane #1152, Jacksonville, FL 32217 | 2017-12-02 |
1548779929 | Acumed Medical Ltd. | Durable Medical Equipment & Medical Supplies | 6653 Powers Avenue, Suite 134, Jacksonville, FL 32217 | 2017-09-28 |
1437685526 | Ward Zeigler | Behavior Technician | 3437 Miruelo Cr. N., Jacksonville, FL 32217 | 2017-05-10 |
1538695754 | Shilonda Peterson-jackson | Technician, Other | 3437 Miruelo Cr N, Jacksonville, FL 32217 | 2017-05-08 |
1114467834 | Louis R. Lothman | Counselor | 3734 San Viscaya Dr., Jacksonville, FL 32217 | 2017-02-28 |
1023490141 | A Gentle Touch Home Health Care LLC. | Home Health | 5991 Chester Avenue, Jacksonville, FL 32217 | 2015-06-25 |
1912320334 | Christopher Marshall Fuller | Developmental Therapist | 5132 Edgeware Ct., Jacksonville, FL 32217 | 2014-01-22 |
1790040020 | Maria R. Tapia | Psychologist | 7680 Smullian Trail West, Jacksonville, FL 32217 | 2012-07-12 |
Find all providers in zip 32217 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
1467935213 | Alexis Almonte | Physician Assistant | 655 W 8th St # C-3, Jacksonville, FL 32209-6511 | 2018-09-07 |
1053851535 | Luciana Oran | Physician Assistant | 4849 Florida Club Cir Apt 3104, Jacksonville, FL 32216-1089 | 2017-03-02 |
1699217463 | Ashley C Moyer | Physician Assistant | 5742 Booth Rd Ste A, Jacksonville, FL 32207-5982 | 2016-11-10 |
1437600889 | Lindsay Elizabeth Murrell | Physician Assistant | 14540 Old Saint Augustine Rd Ste 2599, Jacksonville, FL 32258-7420 | 2016-10-20 |
1992178719 | Sonila Musta-kina | Physician Assistant | 1633 Race Track Rd Ste 101, Jacksonville, FL 32259-3237 | 2015-11-02 |
1922409580 | Lindsey Beth Hollingsworth | Physician Assistant | 841 Prudential Dr Ste 1900, Jacksonville, FL 32207-8373 | 2014-09-12 |
1487905220 | Krystin Michelle Greene | Physician Assistant | 4085 University Blvd S Ste 3, Jacksonville, FL 32216-4362 | 2012-09-19 |
1790034296 | Gary Robertson | Physician Assistant | 12964 Winthrop Cove Dr, Jacksonville, FL 32224-7503 | 2012-08-30 |
1366711905 | Jeremiah Taejong Oh | Physician Assistant | 3d Battalion, 8th Marines Psc Box 20104, Camp Lejeune, Jacksonville, NC 28542-0104 | 2011-12-28 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32217 |
Please comment or provide details below to improve the information on MIRIAN ANTELO COUCH.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.