Provider Demographics
NPI:1477753846
Name:COUCH, HAROLD MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:MATTHEW
Last Name:COUCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MATTHEW
Other - Middle Name:HAROLD
Other - Last Name:COUCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:601 7TH ST S STE 510
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4736
Mailing Address - Country:US
Mailing Address - Phone:727-893-6480
Mailing Address - Fax:813-893-6481
Practice Address - Street 1:601 7TH ST S STE 510
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4736
Practice Address - Country:US
Practice Address - Phone:727-893-6480
Practice Address - Fax:813-893-6481
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0013121208600000X, 390200000X
FLME102879208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003708400Medicaid