Provider Demographics
NPI:1396809141
Name:COHEN, RACHEL ALLYSSA (PT)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ALLYSSA
Last Name:COHEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20120 NE 23RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1810
Mailing Address - Country:US
Mailing Address - Phone:305-343-6144
Mailing Address - Fax:305-967-8863
Practice Address - Street 1:2142 NE 123RD ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2902
Practice Address - Country:US
Practice Address - Phone:305-343-6144
Practice Address - Fax:305-967-8863
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 19576174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL886697000Medicaid