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Individual

EILEEN M COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
14551 HOPE CENTER LOOP STE 200, FORT MYERS, FL 33912-4705
(239) 264-7026
(239) 567-3679
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9101411
FL
363A00000X
Physician Assistant
363AS0400X
Surgical Physician Assistant
PA9101411
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
291064100
FL
05
2911064100
FL
01
970019944
MEDICAID RR
FL
01
PA9101411
PA LICENSE
FL
Enumeration date
04/06/2006
Last updated
05/16/2025
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