Healthcare Provider Details

I. General information

NPI: 1982970745
Provider Name (Legal Business Name): JOSE V COBA MD MPH PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2012
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 GRAND CANAL DR STE 400
MIAMI FL
33144-2570
US

IV. Provider business mailing address

85 GRAND CANAL DR STE 400
MIAMI FL
33144-2570
US

V. Phone/Fax

Practice location:
  • Phone: 305-260-0200
  • Fax: 305-260-0061
Mailing address:
  • Phone: 305-260-0200
  • Fax: 305-260-0061

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME90693
License Number StateFL

VIII. Authorized Official

Name: DR. JOSE V COBA
Title or Position: PRESIDENT
Credential: MD
Phone: 954-603-1182