1427671643 NPI number — REGINA F COOPER

Table of content: REGINA F COOPER (NPI 1427671643)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427671643 NPI number — REGINA F COOPER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COOPER
Provider First Name:
REGINA
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427671643
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/18/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2627 NE 203RD ST STE 109
Provider Second Line Business Mailing Address:
COOPER MEDICAL MANAGEMENT
Provider Business Mailing Address City Name:
AVENTURA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33180-1945
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-661-7227
Provider Business Mailing Address Fax Number:
305-682-8994

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2627 NE 203RD ST STE 109
Provider Second Line Business Practice Location Address:
SUITE 109
Provider Business Practice Location Address City Name:
AVENTURA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33180-1945
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-661-7227
Provider Business Practice Location Address Fax Number:
305-682-8994
Provider Enumeration Date:
05/21/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 247ZC0005X , with the licence number:  10D2181154 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 291U00000X , with the licence number: 10D2181154 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10D2181154 . This is a "CLIA NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 13-64-2027757 . This is a "BIOMEDICAL WASTE CLINICAL LABORATORY" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2-15 . This is a "HEALTH, LIFE, ANNUITIES AND VARIABLE CONTRACTS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 6011757 . This is a "HEALTH CARE CLINIC ESTABLISHMENT" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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