Provider Demographics
NPI:1215131388
Name:CERNUDA AND COHEN M.D.S P.A.
Entity type:Organization
Organization Name:CERNUDA AND COHEN M.D.S P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-654-8100
Mailing Address - Street 1:4519 GEORGE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-7329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4900 N HABANA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-6815
Practice Address - Country:US
Practice Address - Phone:813-876-6311
Practice Address - Fax:813-879-1635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0015736207RP1001X
FL0025006207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL00841Medicare ID - Type UnspecifiedCERNUDA AND COHEN M.D.S
FLD53770Medicare UPIN
FL29767Medicare ID - Type UnspecifiedCHARLES E. CERNUDA
FLD53712Medicare UPIN
FL29863Medicare ID - Type UnspecifiedRICHARD D. COHEN