Healthcare Provider Details

I. General information

NPI: 1356598429
Provider Name (Legal Business Name): DJAMILLE JUDITH COHEN RD, CNSD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 ALTON RD DIETITIAN'S OFFICE - FOOD AND NUTRITION SERVICES
MIAMI BEACH FL
33140-2800
US

IV. Provider business mailing address

4300 ALTON RD DIETITIAN'S OFFICE - FOOD AND NUTRITION SERVICES
MIAMI BEACH FL
33140-2800
US

V. Phone/Fax

Practice location:
  • Phone: 305-674-2121
  • Fax: 305-674-2234
Mailing address:
  • Phone: 305-674-2121
  • Fax: 305-674-2234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number934284
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: