Provider Demographics
NPI:1366422933
Name:COUPLAND, JOAN DIANE (MD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:DIANE
Last Name:COUPLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 TUSKAWILLA RD STE 221
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5289
Mailing Address - Country:US
Mailing Address - Phone:407-775-5315
Mailing Address - Fax:407-287-6835
Practice Address - Street 1:1425 TUSKAWILLA RD STE 221
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5289
Practice Address - Country:US
Practice Address - Phone:407-775-5315
Practice Address - Fax:407-287-6835
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME79870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00370860OtherMEDICARE RAILROAD INDIVID
FL276167000Medicaid
FL205215706OtherTAX ID
FLDF5015OtherMEDICARE RAILROAD GROUP
FL276167000Medicaid
FLDF5015OtherMEDICARE RAILROAD GROUP