Individual
DR. ETHAN NATHANIEL COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 425-2285
(386) 425-7522
Mailing address
PO BOX 732901, DALLAS, TX 75373-2901
(386) 226-4590
(386) 226-3371
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME121066
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013592800
—
FL
Enumeration date
06/08/2011
Last updated
02/11/2016
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