Healthcare Provider Details

I. General information

NPI: 1477202125
Provider Name (Legal Business Name): JULIET COOKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 W ATLANTIC AVE
DELRAY BEACH FL
33445-4637
US

IV. Provider business mailing address

8137 SOUTHGATE BLVD
NORTH LAUDERDALE FL
33068-1000
US

V. Phone/Fax

Practice location:
  • Phone: 561-628-9924
  • Fax:
Mailing address:
  • Phone: 954-274-7762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License NumberTT7979
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: