Charlene M Couillard, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9102270 Issued in FL

Practice address

60 Westminster St N
Suite a
Lehigh Acres, FL 33936-6518

Phone

(239) 368-1808

NPI assigned

Oct 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Housecalls Express Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Stuart, FL
  • NPI 1346349958
  NPD (past)

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

{
    "created_epoch": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397433600000",
    "number": "1255329678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8851 BOARDROOM CIR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339194888",
            "telephone_number": "239-481-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WESTMINSTER ST N",
            "address_2": "SUITE A",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339366518",
            "telephone_number": "239-368-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUILLARD",
        "first_name": "CHARLENE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2014-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9102270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291756400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosaliz Corvo Reyes
• Surimay Cosme Hevia
• Lazara Claudia Costa Casanova
• Yaidi Coto Alamo
• Yamile Couce
• Crafty Counseling LLC
• Dailenis Creagh Suarez
• Yohana Crespo Ortega
• Crimson Early Learning, LLC.
• Cross Key Healthcare

• Physician Assistant in Lehigh Acres, FL
• Providers in Lehigh Acres, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.