Provider Demographics
NPI:1790588309
Name:HERNANDEZ COHEN, ISAAC DAVID
Entity type:Individual
Prefix:
First Name:ISAAC
Middle Name:DAVID
Last Name:HERNANDEZ COHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 UNDERWOOD TRL UNIT B
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-5744
Mailing Address - Country:US
Mailing Address - Phone:786-420-9931
Mailing Address - Fax:
Practice Address - Street 1:8 WILDWOOD LN
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137-3221
Practice Address - Country:US
Practice Address - Phone:386-251-3350
Practice Address - Fax:866-247-1790
Is Sole Proprietor?:No
Enumeration Date:2025-03-29
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-423860106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician