Provider Demographics
NPI:1225006455
Name:AVENTURA ORTHOPAEDICS AND SPORTS MEDICINE, P.A.
Entity Type:Organization
Organization Name:AVENTURA ORTHOPAEDICS AND SPORTS MEDICINE, P.A.
Other - Org Name:BRAD K. COHEN, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-674-5956
Mailing Address - Street 1:PO BOX 801734
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33280-1734
Mailing Address - Country:US
Mailing Address - Phone:305-674-5956
Mailing Address - Fax:786-923-3002
Practice Address - Street 1:20601 E DIXIE HWY
Practice Address - Street 2:SUITE 330
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1540
Practice Address - Country:US
Practice Address - Phone:305-674-5956
Practice Address - Fax:786-923-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME87610207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Not Answered207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK5404Medicare ID - Type UnspecifiedGROUP
FLI03789Medicare UPIN