Provider Demographics
NPI:1730276023
Name:COHEN, ERIC ALAN (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ALAN
Last Name:COHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 SW 97TH AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-1494
Mailing Address - Country:US
Mailing Address - Phone:305-274-2888
Mailing Address - Fax:305-274-9889
Practice Address - Street 1:7000 SW 97TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-1494
Practice Address - Country:US
Practice Address - Phone:305-274-2888
Practice Address - Fax:305-274-9889
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH002694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55697Medicare UPIN
FL88121Medicare ID - Type Unspecified