Healthcare Provider Details

I. General information

NPI: 1306536073
Provider Name (Legal Business Name): LILI COHEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 LEXINGTON GREEN LN
SANFORD FL
32771-1005
US

IV. Provider business mailing address

920 LEXINGTON GREEN LN
SANFORD FL
32771-1005
US

V. Phone/Fax

Practice location:
  • Phone: 407-392-1058
  • Fax:
Mailing address:
  • Phone: 407-392-1058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS22799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: