Healthcare Provider Details

I. General information

NPI: 1518785757
Provider Name (Legal Business Name): MICHELLE D COHEN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2024
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13590 S JOG RD STE 5
DELRAY BEACH FL
33446-3807
US

IV. Provider business mailing address

13590 S JOG RD STE 5
DELRAY BEACH FL
33446-3807
US

V. Phone/Fax

Practice location:
  • Phone: 561-496-2200
  • Fax:
Mailing address:
  • Phone: 561-894-1001
  • Fax: 561-894-1011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE D COHEN
Title or Position: OWNER
Credential: MD
Phone: 561-894-1001