Provider Demographics
NPI:1114320330
Name:REBECCA S. COHEN, MD, LLC
Entity Type:Organization
Organization Name:REBECCA S. COHEN, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:S
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-404-0545
Mailing Address - Street 1:3665 BEE RIDGE RD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1054
Mailing Address - Country:US
Mailing Address - Phone:941-404-0545
Mailing Address - Fax:941-924-6422
Practice Address - Street 1:3665 BEE RIDGE RD
Practice Address - Street 2:SUITE 306
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1054
Practice Address - Country:US
Practice Address - Phone:941-404-0545
Practice Address - Fax:941-924-6422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1124052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty