Healthcare Provider Details

I. General information

NPI: 1285019562
Provider Name (Legal Business Name): JANE COHN PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANE COHN

II. Dates (important events)

Enumeration Date: 07/28/2015
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4243 NW FEDERAL HWY
JENSEN BEACH FL
34957-3600
US

IV. Provider business mailing address

3521 SW BLACKBERRY LN
PALM CITY FL
34990-6901
US

V. Phone/Fax

Practice location:
  • Phone: 215-527-5094
  • Fax:
Mailing address:
  • Phone: 215-527-5094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberPA9108830
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9108830
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number1285019562
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: