Healthcare Provider Details

I. General information

NPI: 1619973377
Provider Name (Legal Business Name): LEDYA COBIAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2151 E COMMERCIAL BLVD STE 203
FT LAUDERDALE FL
33308-3807
US

IV. Provider business mailing address

2151 E COMMERCIAL BLVD STE 203
FT LAUDERDALE FL
33308-3807
US

V. Phone/Fax

Practice location:
  • Phone: 954-489-2260
  • Fax: 954-489-2261
Mailing address:
  • Phone: 954-489-2260
  • Fax: 954-489-2261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME58079
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: