Healthcare Provider Details

I. General information

NPI: 1487898706
Provider Name (Legal Business Name): ERINN O. COOKE M.D., MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2009
Last Update Date: 11/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD DEPARTMENT OF RADIOLOGY, UNIV OF FLORIDA RM G347
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

PO BOX 100374 DEPARTMENT OF RADIOLOGY, UNIV OF FLORIDA RM G347
GAINESVILLE FL
32610-0374
US

V. Phone/Fax

Practice location:
  • Phone: 352-265-0438
  • Fax:
Mailing address:
  • Phone: 352-265-0438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME120788
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: