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Individual

MR. JONATHAN M. COHEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC., A.P.

Contact information

Practice address
721 RIDGEWOOD AVE., STE. 9, HOLLY HILL,, FL 32117
(386) 947-9009
Mailing address
1815 LINDA AVE, ORMOND BEACH, FL 32174-7245
(386) 947-9009

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP1615
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000749494
AETNA PIN
FL
01
CO777
BCBS PROVIDER #
FL
Enumeration date
03/06/2007
Last updated
07/08/2007
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