Provider Demographics
NPI:1538280391
Name:COHEN, CRAIG (PT)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:COHEN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2142 NE 123RD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2902
Mailing Address - Country:US
Mailing Address - Phone:305-967-8976
Mailing Address - Fax:305-967-8863
Practice Address - Street 1:2142 NE 123RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2902
Practice Address - Country:US
Practice Address - Phone:305-967-8976
Practice Address - Fax:305-967-8863
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT179452251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY8970Medicare ID - Type UnspecifiedPHYSICAL THERAPIST