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NPI Code Detail

MEDICARE: KRISTEN COHEN PTA

MEDICARE: KRISTEN COHEN PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantPTA25084FL

General Provider Information

NPI Number : 1609385228
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTEN COHEN PTA
Provider Business Mailing Address
First Line : 4700 BUGGY WHIP LN APT 2
Second Line :
City : ORLANDO
State : FL
Zip : 32812-5243
Country : US
Telephone Number : 727-504-6781
Fax Number :
Provider Business Practice Location Address
First Line : 4680 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32807-1182
Country : US
Telephone Number : 407-852-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2017
Last Update Date : 04/22/2019

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