Provider Demographics
NPI:1417907304
Name:COBA, JOSE V (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:V
Last Name:COBA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:304 INDIAN TRCE
Mailing Address - Street 2:SUITE 191
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2996
Mailing Address - Country:US
Mailing Address - Phone:954-372-9440
Mailing Address - Fax:954-513-4641
Practice Address - Street 1:4800 N STATE ROAD 7
Practice Address - Street 2:SUITE F103
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33319-5811
Practice Address - Country:US
Practice Address - Phone:954-372-9440
Practice Address - Fax:954-513-4641
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2016-04-06
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Provider Licenses
StateLicense IDTaxonomies
FLME90693208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE8793BMedicare PIN
FLH75723Medicare UPIN
E8793BMedicare PIN