Provider Demographics
NPI:1124462783
Name:COFNAS, PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:COFNAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12516 GROSS POINTE DR
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6236
Mailing Address - Country:US
Mailing Address - Phone:214-645-9729
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:1210 S OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7205
Practice Address - Country:US
Practice Address - Phone:561-263-5007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2022-08-22
Deactivation Date:2022-06-27
Deactivation Code:
Reactivation Date:2022-07-21
Provider Licenses
StateLicense IDTaxonomies
TXS58672085R0202X
FLME1533302085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology