Provider Demographics
NPI:1770917924
Name:COGEN, RAZELLE CAROL (PA-C)
Entity type:Individual
Prefix:MS
First Name:RAZELLE
Middle Name:CAROL
Last Name:COGEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8905 SW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2227
Mailing Address - Country:US
Mailing Address - Phone:305-667-8686
Mailing Address - Fax:305-667-8086
Practice Address - Street 1:8905 SW 87TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2227
Practice Address - Country:US
Practice Address - Phone:305-667-8686
Practice Address - Fax:305-667-8086
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9107115363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant