Healthcare Provider Details

I. General information

NPI: 1942126610
Provider Name (Legal Business Name): TRITON MEDICAL GROUP COOPER CITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 EMBASSY DR STE5
COOPER CITY FL
33026
US

IV. Provider business mailing address

2525 EMBASSY DR STE 5
COOPER CITY FL
33026
US

V. Phone/Fax

Practice location:
  • Phone: 754-400-5608
  • Fax:
Mailing address:
  • Phone: 754-400-5608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH COHEN
Title or Position: CEO
Credential:
Phone: 754-400-5608