Provider Demographics
NPI:1619284940
Name:COHEN, DENISE HACKETT (DO)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:HACKETT
Last Name:COHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NW 49TH ST STE 125
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-3750
Mailing Address - Country:US
Mailing Address - Phone:954-473-7642
Mailing Address - Fax:954-473-7686
Practice Address - Street 1:5353 N FEDERAL HWY STE 300
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-3236
Practice Address - Country:US
Practice Address - Phone:954-958-5250
Practice Address - Fax:954-958-5251
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10137207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS10137OtherMEDICAL LICENSE