Provider Demographics
NPI:1073551545
Name:COKER, ALICIA D (MD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:D
Last Name:COKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 S MIAMI AVE STE 605
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4248
Mailing Address - Country:US
Mailing Address - Phone:305-392-0449
Mailing Address - Fax:866-869-0472
Practice Address - Street 1:3661 S MIAMI AVE STE 605
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4248
Practice Address - Country:US
Practice Address - Phone:305-392-0449
Practice Address - Fax:866-869-0472
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83860207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLI01959Medicare UPIN
FL81662Medicare ID - Type Unspecified