| Stanley A Cohen Do Pa | |
|
605 Palencia Club Dr # 201 St Augustine FL 32095-6901 | |
| (904) 808-8595 | |
| (904) 808-8596 |
| Full Name | Stanley A Cohen Do Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 605 Palencia Club Dr # 201, St Augustine, Florida |
| Authorized Official Name and Position | Shanan Moore (PRACTICE MANAGER) |
| Authorized Official Contact | 9048088595 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanley A Cohen Do Pa 605 Palencia Club Dr # 201 St Augustine FL 32095-6901 Ph: (904) 808-8595 | Stanley A Cohen Do Pa 605 Palencia Club Dr # 201 St Augustine FL 32095-6901 Ph: (904) 808-8595 |
| NPI Number | 1285809012 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 09/21/2022 |
| Certification Date | 09/21/2022 |
| Medicare PECOS PAC ID | 3173691698 |
|---|---|
| Medicare Enrollment ID | O20081009000674 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285809012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | OS7389 (Florida) | Primary |
| Provider Name | Michael M Speisman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205856978 PECOS PAC ID: 2961404736 Enrollment ID: I20070207000291 |
| Provider Name | Stanley A Cohen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457437584 PECOS PAC ID: 6305914920 Enrollment ID: I20081009000619 |
| Provider Name | Zuzana Segev |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497155741 PECOS PAC ID: 2961623822 Enrollment ID: I20141020000519 |
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