Healthcare Provider Details
I. General information
NPI: 1255331070
Provider Name (Legal Business Name): SHELDON COHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/22/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9000 SW 137TH AVE #115
MIAMI FL
33186-1411
US
IV. Provider business mailing address
9000 SW 137TH AVE #115
MIAMI FL
33186-1411
US
V. Phone/Fax
- Phone: 305-380-6773
- Fax: 786-533-1502
- Phone: 305-380-6773
- Fax: 786-533-1502
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | ME20270 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: