Organization Active NPI

CQC Wound Clinic PLLC

  • Wound Care Registered Nurse
  • Plantation, FL
National Provider Identifier
1114803996
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Wound Care Registered NurseTaxonomy code 163WW0000X
Legal business name
CQC WOUND CLINIC PLLC
Practice address
4101 NW 3Rd CT Ste 15
Plantation, FL 33317-2830
Phone
(786) 207-4788
Fax
(954) 568-8630
NPI assigned
Aug 15, 2025
Last updated
Feb 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sidney Coupet, DO, MPH, MHSNPI 1285803262
Title
Physician Owner
Phone
(786) 207-4788

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Wound Care Registered Nurse 163WW0000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

4101 NW 3Rd CT Ste 15
Plantation, FL 33317-2830

Mailing address

PO Box 91
Hallandale Beach, FL 33008-0091

Other practice location 1

1600 S Federal Hwy
Pompano Beach, FL 33062-7500
Phone (786) 207-4788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260609003087 FL Part B Supplier - Clinic/Group Practice 7214408376 Receives reassigned benefits from 1 practitioner
Practice locations: Plantation, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2335609CQC Wound Clinic LLC4101 NW 3Rd Court Unit 15, Plantation, FL 33317Certificate of waiverDec 14, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1114803996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330080091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 NW 3RD CT STE 15",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333172830",
            "telephone_number": "786-207-4788",
            "fax_number": "954-568-8630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 S Federal Hwy",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330627500",
            "country_code": "US",
            "telephone_number": "786-207-4788",
            "fax_number": "954-568-8630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CQC WOUND CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "COUPET",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "786-207-4788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO, MPH, MHS"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.