=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861440034
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATALIA KOGAN DC, ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2006
-----------------------------------------------------
Last Update Date | 12/02/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 909 N MIAMI BEACH BLVD SUITE 403
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33162-3712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-940-3506
-----------------------------------------------------
Fax | 305-944-8055
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 909 N MIAMI BEACH BLVD SUITE 403
-----------------------------------------------------
City | NORTH MIAMI BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33162-3712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 305-940-3506
-----------------------------------------------------
Fax | 305-944-8055
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | ARNP 9326379
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 111NN0400X
-----------------------------------------------------
Taxonomy Name | Neurology Chiropractor
-----------------------------------------------------
License Number | 00016
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 111NN0400X
-----------------------------------------------------
Taxonomy Name | Neurology Chiropractor
-----------------------------------------------------
License Number | CH 8555
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------