MIRIAN ANTELO COUCH


Address: 6555 Chester Ave Ste 1, Jacksonville, FL 32217
Phone: 9043096504

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA9106827 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
BCBS Y0FR9 01

Office Location

Street Address 6555 CHESTER AVE STE 1
City JACKSONVILLE
State FL
Zip Code 32217

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City JACKSONVILLE
Zip Code 32217

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Dataset Information

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.

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