Basic Information
| Provider Information | |||||||||
| NPI: | 1548267065 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COONEY | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 N DIXIE HWY | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334012712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618338893 | ||||||||
| FaxNumber: | 5618384397 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 N DIXIE HWY | ||||||||
| Address2: | STE 103 | ||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334012712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5618338893 | ||||||||
| FaxNumber: | 5618338939 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2005 | ||||||||
| LastUpdateDate: | 08/28/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | ME0035771 | FL | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 043911800 | 05 | FL | MEDICAID |