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General NPI Number Information
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NPI Number | 1679567333
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Entity Type | Organization
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Legal Business Name | EDWARD M. COOPERSMITH & RONALD J. SCOTT, M.D., PA.
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 5333 N DIXIE HWY SUITE 201
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3414
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Country | US
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Telephone | 954-491-3440
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Fax | 954-491-8510
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Provider Business Mailing Address
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Address Line | 5333 N DIXIE HWY SUITE 201
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3414
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Country | US
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Telephone | 954-491-3440
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Fax | 954-491-8510
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Authorized Official
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Title or Position | MANAGER
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Name | MR. NATHAN COOPERSMITH
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Credential | M.B.A.
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Telephone | 954-491-3440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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