Individual
MABLE COOKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
545 SW 60TH AVE, PLANTATION, FL 33317-3947
(954) 581-8671
Mailing address
545 SW 60TH AVE, PLANTATION, FL 33317-3947
(954) 581-8671
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
C200545378670
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300063000
—
FL
Enumeration date
04/24/2008
Last updated
04/24/2008
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