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General NPI Number Information
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NPI Number | 1093951279
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Entity Type | Individual
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Provider Name | ALBERT E COOPER JR.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 1201 NW 16TH ST
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City | MIAMI
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State | FL
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Zip | 33125-1624
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Country | US
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Telephone | 305-575-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 298 SW WALKING PATH
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City | STUART
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State | FL
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Zip | 34997-3038
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Country | US
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Telephone | 561-714-1281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN5182570
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License Number State | FL
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