Individual
MARISA P. COOKE
Active
Individual
MARISA P. COOKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085.003112
IL
363AM0700X
Medical Physician Assistant
PA9104877
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9104877
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009120300
—
FL
01
—
PA9104877
MEDICAL LICENSE
FL
Enumeration date
01/09/2008
Last updated
06/20/2019
Update your record
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