Provider Demographics
NPI:1992700660
Name:COCORES, JAMES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:COCORES
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 1:5301 N FEDERAL HWY
Mailing Address - Street 2:STE 270
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-4910
Mailing Address - Country:US
Mailing Address - Phone:561-242-6628
Mailing Address - Fax:
Practice Address - Street 1:5301 N FEDERAL HWY
Practice Address - Street 2:STE 270
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-4910
Practice Address - Country:US
Practice Address - Phone:561-242-6628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-17
Last Update Date:2008-04-08
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
FLME 766352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE71913Medicare UPIN
FL46210AMedicare ID - Type Unspecified
FL46210ZMedicare PIN