Healthcare Provider Details
I. General information
NPI: 1255520656
Provider Name (Legal Business Name): AVENTURA NEUROLOGY CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/22/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
21000 NE 28TH AVE #205
AVENTURA FL
33180-1421
US
IV. Provider business mailing address
21000 NE 28TH AVE #205
AVENTURA FL
33180-1421
US
V. Phone/Fax
- Phone: 305-933-5993
- Fax:
- Phone: 305-933-5993
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LEONARD
V
COHEN
Title or Position: OWNER
Credential: MD
Phone: 305-933-5993