Individual provider Active NPI

Jose V Coba, MD

  • General Practice Physician
  • Lauderdale Lakes, FL
National Provider Identifier
1417907304
Registry record updated Apr 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME90693 Issued in FL
Practice address
4800 N State Road 7
Suite F103
Lauderdale Lakes, FL 33319-5811
Phone
(954) 372-9440
Fax
(954) 513-4641
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME90693 FL Primary

Addresses

Primary practice location

4800 N State Road 7
Suite F103
Lauderdale Lakes, FL 33319-5811

Mailing address

304 Indian Trce
Suite 191
Weston, FL 33326-2996
Phone (954) 372-9440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
A Class Medical Inc Past Accepting new patients
Friends Testing Facility Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459900800000",
    "number": "1417907304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 INDIAN TRCE",
            "address_2": "SUITE 191",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333262996",
            "telephone_number": "954-372-9440",
            "fax_number": "954-513-4641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 N STATE ROAD 7",
            "address_2": "SUITE F103",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195811",
            "telephone_number": "954-372-9440",
            "fax_number": "954-513-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBA",
        "first_name": "JOSE",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2016-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME90693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.