Provider Demographics
NPI:1194920157
Name:COHEN'S FASHION OPTICAL
Entity type:Organization
Organization Name:COHEN'S FASHION OPTICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:954-432-1532
Mailing Address - Street 1:11401 PINES BLVD STE 352
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4105
Mailing Address - Country:US
Mailing Address - Phone:954-432-1532
Mailing Address - Fax:954-436-0636
Practice Address - Street 1:11401 PINES BLVD STE 352
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4105
Practice Address - Country:US
Practice Address - Phone:954-432-1532
Practice Address - Fax:954-436-0636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier