Provider Demographics
NPI:1942221460
Name:COONEY, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:COONEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 BURNS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4625
Mailing Address - Country:US
Mailing Address - Phone:561-694-7776
Mailing Address - Fax:561-694-3099
Practice Address - Street 1:1411 N FLAGLER DR STE 9800
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3423
Practice Address - Country:US
Practice Address - Phone:561-694-7776
Practice Address - Fax:561-694-3099
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055243207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL057247100Medicaid
FL057247100Medicaid
FL057247100Medicaid