Provider Demographics
NPI:1861440034
Name:KOGAN, NATALIA (DC, ARNP)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:
Last Name:KOGAN
Suffix:
Gender:F
Credentials:DC, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N MIAMI BEACH BLVD
Mailing Address - Street 2:SUITE 403
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-3712
Mailing Address - Country:US
Mailing Address - Phone:305-940-3506
Mailing Address - Fax:305-944-8055
Practice Address - Street 1:909 N MIAMI BEACH BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3712
Practice Address - Country:US
Practice Address - Phone:305-940-3506
Practice Address - Fax:305-944-8055
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9326379363LF0000X
TX00016111NN0400X
FLCH 8555111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL331208OtherWELLCARE
FL89754OtherBC BS
FL15117OtherHUMANA
FL302784OtherAVMED
FL302784OtherAVMED
FL89754AMedicare ID - Type Unspecified