Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | ME76715 | FL |
NPI | 1740282292 |
---|---|
Provider Name | Randolph Cohen |
First Address | Miramar, FL 33025-3925 |
Second Address | Coral Springs, FL 33076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 16/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
255322800 | (05) | FL |
G82277 | (02) | FL |