Organization
COGENT HEALTHCARE OF JACKSONVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA FALL (MANAGER)
(253) 682-6040
Entity
Organization
Contact information
Practice address
4125 W SAMPLE RD, COCONUT CREEK, FL 33073-4456
(954) 968-8333
Mailing address
5410 MARYLAND WAY STE 300, BRENTWOOD, TN 37027-5339
(615) 577-6340
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001651535
—
FL
Enumeration date
05/04/2021
Last updated
03/07/2025
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