Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | ME12188 | FL |
N | 213ES0103X | Foot & Ankle Surgery | PO1290 | FL |
NPI | 1093259459 |
---|---|
Provider Name | Mr. Scott Cook |
First Address | Hollywood, FL 33021-5652 |
Second Address | Hollywood, FL 33021-5652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2016 |
Last Update Date | 05/12/2016 |