Provider Demographics
NPI:1396733424
Name:COHEN, JONATHAN J (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:J
Last Name:COHEN
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 1:1321 NW 14TH ST
Mailing Address - Street 2:STE. 207
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1673
Mailing Address - Country:US
Mailing Address - Phone:305-324-7000
Mailing Address - Fax:305-326-9673
Practice Address - Street 1:1321 NW 14TH ST
Practice Address - Street 2:STE. 207
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1673
Practice Address - Country:US
Practice Address - Phone:305-324-7000
Practice Address - Fax:305-326-9673
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2009-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0031465207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL066463400Medicaid
FL066463400Medicaid