Healthcare Provider Details

I. General information

NPI: 1245260488
Provider Name (Legal Business Name): HEIDI COHEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 45TH ST
WEST PALM BEACH FL
33407-2413
US

IV. Provider business mailing address

PO BOX 863481
ORLANDO FL
32886-3481
US

V. Phone/Fax

Practice location:
  • Phone: 561-844-6300
  • Fax: 904-346-0113
Mailing address:
  • Phone: 305-749-0289
  • Fax: 904-346-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME0065693
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: