Healthcare Provider Details

I. General information

NPI: 1740399963
Provider Name (Legal Business Name): ELIAHOU COHEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6290 LINTON BLVD STE 201
DELRAY BEACH FL
33484-6409
US

IV. Provider business mailing address

2600 LAKE LUCIEN DR STE 180
MAITLAND FL
32751-7235
US

V. Phone/Fax

Practice location:
  • Phone: 561-495-1337
  • Fax: 561-495-5892
Mailing address:
  • Phone: 407-875-2080
  • Fax: 407-875-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberME82108
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: