Healthcare Provider Details

I. General information

NPI: 1396809141
Provider Name (Legal Business Name): RACHEL ALLYSSA COHEN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 05/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 NE 123RD ST
NORTH MIAMI FL
33181-2902
US

IV. Provider business mailing address

20120 NE 23RD CT
MIAMI FL
33180-1810
US

V. Phone/Fax

Practice location:
  • Phone: 305-343-6144
  • Fax: 305-967-8863
Mailing address:
  • Phone: 305-343-6144
  • Fax: 305-967-8863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT 19576
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: