Provider Demographics
NPI:1255436176
Name:COHN-GELWASSER, ELISABETH E (MD)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:E
Last Name:COHN-GELWASSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-3611
Mailing Address - Country:US
Mailing Address - Phone:954-966-5700
Mailing Address - Fax:954-987-3728
Practice Address - Street 1:2209 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-3611
Practice Address - Country:US
Practice Address - Phone:954-966-5700
Practice Address - Fax:954-987-3728
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61852173000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL374043900Medicaid
FL374043900Medicaid
FL23187YMedicare PIN