Healthcare Provider Details

I. General information

NPI: 1801074083
Provider Name (Legal Business Name): DENISE ROSENTHAL COCHRAN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2008
Last Update Date: 02/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD 118-A
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

1600 SW ARCHER RD 118-A
GAINESVILLE FL
32610-3003
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax:
Mailing address:
  • Phone: 352-376-1611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number9203506
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: