Provider Demographics
NPI:1578639118
Name:PC MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:PC MEDICAL ASSOCIATES
Other - Org Name:PCP OF MARGATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-968-9993
Mailing Address - Street 1:1316 N STATE RD 7
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063
Mailing Address - Country:US
Mailing Address - Phone:954-968-9993
Mailing Address - Fax:954-968-9910
Practice Address - Street 1:1316 N STATE RD 7
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063
Practice Address - Country:US
Practice Address - Phone:954-968-9993
Practice Address - Fax:954-968-9910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21992Medicaid
FLCH7598OtherRAILROAD MEDICARE
FL=========OtherCOMMERCIAL TAX ID