Active NPI
Dublain Coulanges
- Physical Therapy Assistant
- Sebring, FL
National Provider Identifier
1801360342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 27896
- Practice address
- 725 S Pine St
Sebring, FL 33870-3654 - Phone
- (863) 385-0161
- NPI assigned
- Jan 17, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 27896 | FL | Primary |
Addresses
Primary practice location
725 S Pine St
Sebring, FL 33870-3654
Mailing address
129 Sanderling Dr
Haines City, FL 33844-8233
Phone (863) 353-1631
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| UNAVALIBLE | Other | BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27896 | FL | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1561939200000",
"number": "1801360342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 SANDERLING DR",
"city": "HAINES CITY",
"state": "FL",
"postal_code": "338448233",
"telephone_number": "863-353-1631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 S PINE ST",
"city": "SEBRING",
"state": "FL",
"postal_code": "338703654",
"telephone_number": "863-385-0161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COULANGES",
"first_name": "DUBLAIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-17",
"last_updated": "2019-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "27896",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "UNAVALIBLE",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sebring, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.