# MARK COCKBURN MD PA

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

## Provider details

- **NPI number:** 1770327702
- **Authorized official:** MARK COCKBURN MD (OWNER)
- **Authorized official phone:** (914) 310-0926

## Contact information

- **Practice address:** 8201 N UNIVERSITY DR STE 204, TAMARAC, FL 33321-1709
- **Practice address phone:** (914) 310-0926
- **Mailing address:** 12990 SW 52ND ST, SOUTHWEST RANCHES, FL 33330-2730
- **Mailing address phone:** (914) 310-0926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | — | — | — |
| 2086S0127X | Trauma Surgery Physician | — | NULL | Yes |
| 2086S0127X | Trauma Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/24/2024
- **Last updated:** 06/24/2024