Healthcare Provider Details

I. General information

NPI: 1962313189
Provider Name (Legal Business Name): HAGIT COHEN MEDINA PHD, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 S UNIVERSITY DR STE 412A
DAVIE FL
33328-5313
US

IV. Provider business mailing address

5400 S UNIVERSITY DR STE 412A
DAVIE FL
33328-5313
US

V. Phone/Fax

Practice location:
  • Phone: 832-331-2158
  • Fax:
Mailing address:
  • Phone: 832-331-2158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT5587
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: