Healthcare Provider Details

I. General information

NPI: 1992700660
Provider Name (Legal Business Name): JAMES COCORES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2005
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date: 03/20/2006
Reactivation Date: 03/27/2006

III. Provider practice location address

5301 N FEDERAL HWY STE 270
BOCA RATON FL
33487-4910
US

IV. Provider business mailing address

5301 N FEDERAL HWY STE 270
BOCA RATON FL
33487-4910
US

V. Phone/Fax

Practice location:
  • Phone: 561-242-6628
  • Fax:
Mailing address:
  • Phone: 561-242-6628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME 76635
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: