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General NPI Number Information
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NPI Number | 1265427587
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Entity Type | Individual
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Provider Name | HEZI COHEN M.D,
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 305 MEMORIAL MEDICAL PKW. SUITE 208
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City | DAYTONA BEACH
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State | FL
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Zip | 32117
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Country | US
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Telephone | 386-231-3525
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Fax | 386-231-3527
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Provider Business Mailing Address
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Address Line | 305 MEMORIAL MEDICAL PKW. SUITE 208
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City | DAYTONA BEACH
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State | FL
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Zip | 32117
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Country | US
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Telephone | 386-231-3525
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Fax | 386-231-3527
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | ME79162
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License Number State | FL
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