Provider Demographics
NPI:1407869712
Name:COHEN, EVELYN (MD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 CANDLESTICK CT
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32514-1549
Mailing Address - Country:US
Mailing Address - Phone:850-505-6463
Mailing Address - Fax:850-477-3296
Practice Address - Street 1:6000 WESR HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32512-0008
Practice Address - Country:US
Practice Address - Phone:850-505-6463
Practice Address - Fax:850-505-6527
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4311171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor