Provider Demographics
NPI:1386986214
Name:COHAN, HOWARD ADAM (DO)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:ADAM
Last Name:COHAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 NE 7TH AVE # 1
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-1210
Mailing Address - Country:US
Mailing Address - Phone:954-424-1100
Mailing Address - Fax:561-988-1845
Practice Address - Street 1:3712 NW 52ND ST
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2706
Practice Address - Country:US
Practice Address - Phone:954-424-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine