Provider Demographics
NPI:1679704779
Name:COHEN, JASON R (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:R
Last Name:COHEN
Suffix:
Gender:M
Credentials:DO
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Other - First Name:
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Mailing Address - Street 1:560 VILLAGE BLVD
Mailing Address - Street 2:SUITE #150
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-1945
Mailing Address - Country:US
Mailing Address - Phone:561-331-8800
Mailing Address - Fax:561-331-8074
Practice Address - Street 1:560 VILLAGE BLVD
Practice Address - Street 2:SUITE #150
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-1945
Practice Address - Country:US
Practice Address - Phone:561-331-8800
Practice Address - Fax:561-331-8074
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2016-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS122122084P0800X, 193200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes193200000XGroupMulti-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry