# HERON LAKES CHIROPRACTIC CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114143278
- **Authorized official:** DR. JARED STEPHAN COHEN D.C. (PRESIDENT)
- **Authorized official phone:** (954) 341-2256

## Contact information

- **Practice address:** 5675 CORAL RIDGE DR, CORAL SPRINGS, FL 33076-3124
- **Practice address phone:** (954) 341-2256
- **Practice address fax:** (954) 341-2264
- **Mailing address:** 5675 CORAL RIDGE DR, CORAL SPRINGS, FL 33076-3124
- **Mailing address phone:** (954) 341-2256
- **Mailing address fax:** (954) 341-2264

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CH8680 | FL | — |
| 111N00000X | Chiropractor | CH8773 | FL | Yes |

## Other

- **Enumeration date:** 04/17/2007
- **Last updated:** 08/22/2020