Organization Active NPI

Fred L Cohen MD PA

  • Specialist
  • Palm Beach Gardens, FL
National Provider Identifier
1760664494
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FRED L COHEN MD PA
Practice address
11211 Prosperity Farms Rd
Suite C109
Palm Beach Gardens, FL 33410-3446
Phone
(561) 738-5095
Fax
(561) 738-5354
NPI assigned
Dec 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Authorized official

Name
Aggie M Lechon
Title
A/R
Phone
(561) 738-5095

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

11211 Prosperity Farms Rd
Suite C109
Palm Beach Gardens, FL 33410-3446

Mailing address

11211 Prosperity Farms Rd
Suite C109
Palm Beach Gardens, FL 33410-3446
Phone (561) 738-5095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080412000050 FL Part B Supplier - Clinic/Group Practice 0547347734 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Beach Gardens, FL

National Provider Directory

National Provider Directory

Locations

11211 Prosperity Farms Rd
Ste C109
Palm Beach Gardens, FL 33410
Phone (561) 627-5292

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197936000000",
    "number": "1760664494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD",
            "address_2": "SUITE C109",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103446",
            "telephone_number": "561-738-5095",
            "fax_number": "561-738-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11211 PROSPERITY FARMS RD",
            "address_2": "SUITE C109",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103446",
            "telephone_number": "561-738-5095",
            "fax_number": "561-738-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED L COHEN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-18",
        "status": "A",
        "authorized_official_last_name": "LECHON",
        "authorized_official_first_name": "AGGIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "A/R",
        "authorized_official_telephone_number": "561-738-5095"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.