1477533370 NPI number — DR. MICHAEL J COHEN MD

Table of content: DR. MICHAEL J COHEN MD (NPI 1477533370)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477533370 NPI number — DR. MICHAEL J COHEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COHEN
Provider First Name:
MICHAEL
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477533370
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
80 W MICHIGAN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32806-4453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-648-4323
Provider Business Mailing Address Fax Number:
407-839-1493

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
80 W MICHIGAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32806-4453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-648-4323
Provider Business Practice Location Address Fax Number:
407-839-1493
Provider Enumeration Date:
01/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2086S0129X , with the licence number:  ME0048437 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 059581100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4008324 . This is a "AETNA PPO ID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 230000341 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 339360 . This is a "UNITED ID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0007911 . This is a "AETNA HMO ID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5795620 . This is a "GHI ID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 05236 . This is a "WELLCARE ID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 47803X . This is a "BC/BS OF FLORIDA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 1791685 . This is a "CIGNA ID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 209960 . This is a "AV-MED ID NUMBER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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