Organization
SEPA DORAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERAL M COHEN ESQ. (EXECUTIVE VICE PRESIDENT)
(305) 596-4288
Entity
Organization
Contact information
Practice address
8000 NW 21ST ST STE 221, DORAL, FL 33122-1620
(305) 596-4288
Mailing address
8000 NW 21ST ST STE 221, DORAL, FL 33122-1620
(305) 596-4288
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
APPLIED FOR PROVIDER NUMBERS
FL
Enumeration date
06/20/2017
Last updated
07/21/2022
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