Provider Demographics
NPI:1376657833
Name:ORTHOPAEDIC AND SPINAL ASSOCIATES OF SOUTH FLORIDA PA
Entity Type:Organization
Organization Name:ORTHOPAEDIC AND SPINAL ASSOCIATES OF SOUTH FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-532-2411
Mailing Address - Street 1:4308 ALTON RD
Mailing Address - Street 2:SUITE 830
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-4556
Mailing Address - Country:US
Mailing Address - Phone:305-532-2411
Mailing Address - Fax:305-532-9793
Practice Address - Street 1:4308 ALTON RD
Practice Address - Street 2:SUITE 830
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-4556
Practice Address - Country:US
Practice Address - Phone:305-532-2411
Practice Address - Fax:305-532-9793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051493207X00000X
FLME0076225207X00000X
FLOS8977208100000X
FLOS10695208100000X
FLPA9102871363A00000X
FLPA9101701363A00000X
FLPA9104491363A00000X
FLPA9105448363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL24028Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER