1063155059 NPI number — AMEE COHEN AND ASSOCIATES

Table of content: (NPI 1063155059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063155059 NPI number — AMEE COHEN AND ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMEE COHEN AND ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1063155059
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1825 NW CORPORATE BLVD STE 110
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33431-8554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-869-7202
Provider Business Mailing Address Fax Number:
561-768-7269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 E ROBINSON ST STE 1120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32801-1962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-869-7202
Provider Business Practice Location Address Fax Number:
561-768-7269
Provider Enumeration Date:
04/18/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KATOPODIS
Authorized Official First Name:
CHRISTIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING DIRECTOR
Authorized Official Telephone Number:
954-869-7202

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 113649200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".